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Seek immediate medical attention (attend A&E or call 999) if experiencing: Severe, persistent vomiting preventing any oral intake, particularly if lasting more than 24 hours Signs of dehydration : Dizziness, reduced urine output, dark urine, rapid heartbeat, or confusion Severe abdominal pain , especially if sudden onset, persistent, or radiating to the back (which may indicate pancreatitisa rare but serious side effect of GLP-1 receptor agonists) [12] [13] Vomiting blood or material resembling coffee grounds Black, tarry stools suggesting gastrointestinal bleeding Right upper abdominal pain, fever, or yellowing of skin/eyes , which may indicate gallbladder disease (GLP-1 receptor agonists have been associated with gallstone formation) [13] [15] Contact your GP, NHS 111, or diabetes specialist nurse within 2448 hours if you experience: Persistent nausea or vomiting that interferes with daily activities or medication adherence Significant unintentional weight loss over a short period Inability to maintain adequate nutrition or hydration Worsening symptoms despite dietary modifications New or worsening reflux symptoms , particularly if associated with difficulty swallowing Unpredictable blood glucose control due to erratic food absorption Routine review with your healthcare provider should occur if: Gastrointestinal symptoms persist beyond 46 weeks of starting or increasing Ozempic dose Symptoms significantly impact quality of life or ability to work You are considering discontinuing the medication due to side effects You require guidance on dietary modifications or symptom management strategies Healthcare professionals should conduct a thorough assessment including medication review, examination for dehydration or nutritional deficiency, and consideration of alternative diagnoses

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