Each card follows the same layout: why it happens, what to try without medicine, over-the-counter options, what to check first, and when to message your care team.
Nausea
Most common early on
The medicine acts on the brain's nausea center and slows stomach emptying, so food sits longer. Nausea is the most common effect and is strongest during dose increases.
Try first
- Smaller, more frequent meals; don't eat past full
- Skip fatty, fried, and spicy foods
- Eat a small breakfast even if queasy — a long fast can worsen it
- Sip cool, clear fluids; skip fizzy drinks
- Ginger or peppermint tea; acupressure bands; fresh air; avoid strong smells
Over-the-counter to try
Ginger (capsules, chews, or tea) · Vitamin B6 (pyridoxine) · Emetrol (phosphorated carbohydrate solution). Follow the package directions.
Check first
Sedating anti-nausea antihistamines — dimenhydrinate (Dramamine), meclizine (Bonine) — can worsen constipation and add to dizziness. On the Wegovy tablet, take any OTC only after the 30-minute morning window.
Message your care team if
Nausea lasts beyond 1–2 weeks at a steady dose, you can't eat or drink enough for more than a day, or it comes with severe stomach pain, fever, or dehydration signs.
Vomiting
Protect your fluids
Same causes as nausea, often set off by eating more than your slowed stomach can hold.
Try first
- Use the nausea steps
- After vomiting, wait 15–30 minutes, then sip small amounts of clear fluid
- Hold off on solid food, then restart with bland, low-fat foods (crackers, toast, rice)
- Make rehydration the priority
Over-the-counter to try
Oral rehydration drinks (Pedialyte, DripDrop) · Emetrol · Ginger if you can keep it down. Follow the package directions.
Check first
Skip NSAIDs (ibuprofen/Advil, naproxen/Aleve) while vomiting — dehydration plus NSAIDs strains the kidneys. If you take the Wegovy tablet and vomit within 30 minutes of it, don't take a replacement dose.
Message your care team if
Vomiting lasts more than 24 hours or returns with every meal, or you can't keep fluids down for 12 hours. Vomiting blood or coffee-ground material is an emergency (see warning signs).
Diarrhea
Hydrate hard
The medicine can speed things up lower in the gut even while the stomach slows.
Try first
- Hydrate with water and electrolyte fluids
- Avoid large, fatty meals and alcohol
- Ease off high-fiber and high-sugar foods for now
- Bland foods (bananas, rice, applesauce, toast) can help
Over-the-counter to try
Loperamide (Imodium A-D) · Bismuth subsalicylate (Pepto-Bismol) · Psyllium fiber (Metamucil). Follow the package directions.
Check first
Bismuth turns stools black, which can hide bleeding — don't use it with blood thinners or an aspirin/salicylate allergy, and not more than 2 days. On the Wegovy tablet, keep bismuth, loperamide, and fiber outside the 30-minute morning window.
Message your care team if
Diarrhea lasts more than 48 hours despite self-care, you have a fever over 101°F, or severe cramping. Black or bloody stools not explained by bismuth need same-day or emergency care.
Constipation
Treat it early
Slower stomach and gut movement — plus eating and drinking less — all slow stool. It's especially common with orforglipron (Foundayo) and semaglutide.
Try first
- Fluids toward 2–3 liters a day
- Build up fruits, vegetables, whole grains, prunes
- Move more — even walking helps
- Don't ignore the urge; act early rather than waiting
Over-the-counter to try
Psyllium fiber (Metamucil) · Docusate stool softener (Colace) · Polyethylene glycol 3350 (MiraLAX) · Magnesium citrate. Follow the package directions.
Check first
If you have any kidney problems, avoid magnesium products (magnesium citrate, milk of magnesia) — use MiraLAX or docusate instead. Anti-nausea antihistamines make constipation worse. On the Wegovy tablet, keep fiber outside the 30-minute morning window.
Message your care team if
No bowel movement for 3+ days despite an OTC laxative, rectal bleeding, or needing a stimulant laxative daily beyond a week. Constipation with belly pain, swelling, and vomiting needs same-day care.
Heartburn & indigestion
Reflux, dyspepsia
A fuller, slower stomach pushes acid back up more easily, so reflux and indigestion are more likely on these medicines.
Try first
- Smaller meals; don't lie down for 2–3 hours after eating
- Avoid fatty, spicy, citrus, tomato, chocolate, coffee, alcohol
- Raise the head of the bed; wear loose clothing
- Skip fizzy drinks
Over-the-counter to try
Calcium carbonate antacids (Tums, Rolaids) for quick relief · Famotidine (Pepcid AC) · Omeprazole (Prilosec OTC) or esomeprazole (Nexium 24HR) for frequent heartburn. Follow the package directions.
Check first
On the Wegovy tablet, take antacids only after the 30-minute morning window. OTC acid reducers (PPIs) are meant for about 14 days — longer use is worth a check-in, partly because they can lower magnesium.
Message your care team if
Heartburn continues after 14 days of an OTC acid reducer, or swallowing is painful or difficult. Vomiting blood or chest pain is an emergency.
Bloating, gas & burping
Eructation, flatulence
Food ferments a little longer in a slower stomach, producing gas and belching.
Try first
- Eat slowly and chew well
- Skip fizzy drinks, gum, and straws (less swallowed air)
- Cut back gas-forming foods for now (beans, cruciferous veg, onions)
- Smaller meals; a short walk after eating
Over-the-counter to try
Simethicone (Gas-X, Mylanta Gas) · Alpha-galactosidase (Beano) before gassy meals · Activated charcoal. Follow the package directions.
Check first
Activated charcoal can soak up other medicines — keep it at least 2 hours from any other pill, including Foundayo. On the Wegovy tablet, take simethicone after the 30-minute window. Bloating with real pain and swelling isn’t just gas.
Message your care team if
Swelling and pain build up, you can't pass gas or stool, or it stops you eating.
Abdominal discomfort
Cramping, aching
Shifts in how the gut moves can cause cramps and diffuse aching.
Try first
- A warm compress or heating pad
- Gentle walking
- Avoid big meals, fatty foods, and alcohol
- Peppermint tea; stay hydrated
Over-the-counter to try
Acetaminophen (Tylenol) — preferred over NSAIDs here · Simethicone if it’s gas-related · Enteric-coated peppermint oil (IBgard). Follow the package directions.
Check first
Avoid NSAIDs (ibuprofen, naproxen) for belly pain, especially if you’re low on fluids. Pain that is severe, or spreads to your back, should not be self-treated.
Message your care team if
Mild cramps last more than a week despite diet changes. Severe or worsening upper-belly pain — especially spreading to the back, or with fever, yellowing, or vomiting — needs same-day or emergency care.
Headache
Often dehydration
Often from not drinking enough, eating too little, or blood-sugar shifts — sometimes a direct effect of the medicine.
Try first
- Drink a big glass of water first
- Don't skip meals
- Rest somewhere quiet and dark; cool compress
- If you take insulin or a sulfonylurea, check your blood sugar
Over-the-counter to try
Acetaminophen (Tylenol) first · Ibuprofen or naproxen only if you’re well-hydrated and not having stomach symptoms. Follow the package directions.
Check first
NSAIDs are hard on the kidneys when you’re low on fluids, so acetaminophen is the safer default. A slower stomach can delay a pill’s effect — don’t take extra doses assuming it "didn’t work."
Message your care team if
The headache is new in pattern, progressive, or not eased by OTC, or comes with dehydration. "Worst headache of your life," or headache with vision changes, confusion, or a stiff neck, is an emergency.
Dizziness & lightheadedness
Check blood sugar
Usually low fluids, a drop in blood pressure on standing, or eating too little — and low blood sugar if you take insulin or a sulfonylurea.
Try first
- Sit or lie down; drink fluids
- Stand up slowly; avoid long standing in the heat
- Eat enough
- Check blood sugar if you're on insulin or a sulfonylurea
Over-the-counter to try
Oral rehydration drinks (Pedialyte, DripDrop) if dehydrated · Glucose tablets or juice if blood sugar is low · Meclizine (Bonine) for spinning-type dizziness. Follow the package directions.
Check first
Meclizine and dimenhydrinate are sedating and can worsen constipation. If you take insulin or a sulfonylurea, check blood sugar before assuming dizziness is harmless. Blood-pressure medicines can add to the effect.
Message your care team if
Dizziness comes with fainting or near-fainting, persists despite drinking fluids, or your blood sugar is confirmed low more than once. Dizziness with chest pain, shortness of breath, or new neurological symptoms is an emergency.
Fatigue
Fuel and rest
Eating and drinking less, electrolyte shifts, disrupted sleep from stomach symptoms, and the body adjusting to weight loss can all add up.
Try first
- Eat enough — don't over-restrict
- Prioritize protein to protect muscle
- Hydrate; keep regular sleep
- Some regular activity actually helps
- Check blood sugar if on insulin or a sulfonylurea
Over-the-counter to try
A multivitamin (with iron if appropriate) · Caffeine in moderation · Electrolyte drinks. Follow the package directions.
Check first
Ongoing tiredness deserves lab work, not just self-care. The Wegovy tablet can raise absorption of levothyroxine — if you take thyroid medicine, your prescriber may monitor your thyroid. Fatigue can also be low blood sugar on insulin or a sulfonylurea.
Message your care team if
Fatigue is severe or worsening, comes with breathlessness, paleness, or a racing heart, interferes with daily life, or lasts beyond the dose-increase period.
Hair thinning
Usually temporary
Some shedding can follow rapid weight loss rather than being a direct drug effect. It's reported in a small share of people across products, and more often in women.
Try first & OTC: enough protein; iron, zinc, biotin, and vitamin D as part of a balanced diet or multivitamin; gentle hair care; patience — it usually settles over a few months. Topical minoxidil 2% (Rogaine for Women) is an option. Follow the package directions.
Check first
Take iron only if a blood test shows you're low. Patchy loss or scalp changes suggest a different cause.
Message your care team if
Loss is severe or patchy, comes with scalp changes, or hasn’t improved after about 6 months at a steady weight.
Injection-site reactions
Injections only
Redness, itching, or soreness where you inject — a local reaction with Wegovy and Zepbound injections. The tablets (Wegovy oral, Foundayo) don’t cause this.
Try first & OTC: rotate sites each week; let refrigerated medicine warm to room temperature first; cool compress after. Hydrocortisone 1% cream (Cortaid) or a non-drowsy antihistamine (cetirizine/Zyrtec, loratadine/Claritin) for itch; acetaminophen for soreness. Follow the package directions.
Check first
Prefer non-drowsy antihistamines — Benadryl (diphenhydramine) is sedating and worsens constipation. Redness at the site is local; hives spreading beyond it, or facial/throat swelling, is an emergency.
Message your care team if
The reaction spreads, shows infection signs (growing redness, warmth, pus, fever), or worsens with each injection.
Skin tingling or sensitivity
Mainly higher-dose Wegovy
Tingling, burning, or extra-sensitive skin can occur — most often at the higher Wegovy dose, and much less with the Wegovy tablet. It's dose-related, usually mild, and tends to settle on its own.
Try first & OTC: loose clothing; gentle, fragrance-free skin products; cool compress. Topical lidocaine (Aspercreme with Lidocaine) or capsaicin cream (Capzasin) for localized burning; acetaminophen for discomfort. Follow the package directions.
Check first
This is mainly a higher-dose Wegovy effect. Other causes (such as low vitamin B12) are worth ruling out.
Message your care team if
It's severe or spreading, comes with weakness or numbness, or hasn't improved in 4–6 weeks at a steady dose.
Faster heartbeat
No OTC — care team
A small rise in heart rate can happen with all of these medicines.
Try first: stay hydrated, go easy on caffeine, and note when it happens.
Check first
There isn't an appropriate over-the-counter option here — heart-rate concerns should go to your care team.
Message your care team if
Your resting heart rate is regularly over 100, or you feel your heart racing or pounding — especially with dizziness, chest pain, or shortness of breath, which is same-day or emergency.
