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Other notable side effects include: Injection site reactions such as redness, itching, or bruising at the injection site Fatigue some patients report feeling more tired than usual Hypoglycaemia low blood sugar is uncommon with Ozempic alone but may occur when used alongside insulin or sulfonylureas (doses of these medications may need adjustment by your prescriber) Important safety warnings from the UK SmPC include: Acute pancreatitis seek immediate medical attention for severe, persistent abdominal pain, with or without vomiting Gallbladder disease including gallstones and inflammation of the gallbladder Diabetic retinopathy complications particularly in patients with pre-existing retinopathy when blood glucose improves rapidly Dehydration and kidney problems severe gastrointestinal side effects may lead to dehydration and acute kidney injury Hypersensitivity reactions including rash, itching and rarely, anaphylactic reactions It is important to note that swollen lymph nodes are not listed among the recognised side effects of Ozempic in the UK SmPC or patient information leaflet

*Correspondence: Xiaoyun Wu, [email protected]

doi:10.1056/nejmoa2403347 4.Shor R, Mihalache A, Noori A, et al