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Weight Management
Weight Management

Does Ozempic Cause Heartburn?

Christine Russell, MS, RD, LD, CDCES
Author: 
Medical Reviewer: 
Christine Russell, MS, RD, LD, CDCES
|
Author: 
Sarah Bullard, MS, RD
Published:
November 6, 2023
Updated on
#
min read
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Table of Contents

Text Link
Weight Management

Key Takeaways

  • Ozempic is an injectable medication that helps to lower blood sugar levels in people with type 2 diabetes.
  • Heartburn is reported by about 2% of people taking Ozempic.
  • A registered dietitian nutritionist can help you individualize your diet and lifestyle to reduce heartburn.

Ozempic is an injectable medication for people with type 2 diabetes.

This medication is generally prescribed if metformin, diet, and exercise have not effectively lowered blood sugar levels and hemoglobin A1C (a three-month average of your blood sugar levels). 

Ozempic works well at reducing overnight and fasting blood sugar levels and hemoglobin A1C.

It can also help people achieve significant weight loss.

While Ozempic has positive effects, it can have undesirable side effects, such as gastrointestinal issues, including heartburn. 

Keep reading to learn about Ozempic and heartburn, tips for reducing this effect, and how a registered dietitian nutritionist (RDN) can help. 

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Does Ozempic Cause Heartburn?

Yes, Ozempic can cause heartburn, but only in about 2% of the participants from the clinical studies. 

In the prescribing information for Ozempic, heartburn is also called:

  • Dyspepsia (indigestion or upset stomach).
  • Eructation (burping).
  • Gastroesophageal reflux disease (reflux).

Interestingly, a 1% higher rate of heartburn was reported in the lower (0.5mg) dose compared to the higher (1mg) dose.

Generally, symptoms increase with a higher dose of medication. 

Researchers evaluated the tolerance of the gastrointestinal(GI) side effects in 803 participants taking Ozempic.

Only 4.3% discontinued Ozempic altogether due to any GI side effect.  

Most people felt the benefits of taking Ozempic outweighed the undesirable GI side effects. 

How Long Does Ozempic Heartburn Last?

GI side effects are common when starting injectable medications like Ozempic and increasing the dosage. 

Most people have a resolution of the GI symptoms spontaneously while still taking the medication. 

There are no specific studies looking at how long people taking Ozempic had heartburn, only if they reported it as a side effect. 

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Potential Causes of Heartburn While Taking Ozempic 

There is no definitive reason why Ozempic causes heartburn in some people.

There are some theories based on how this medication works. 

Slowed Digestion

Ozempic is a type of medication called GLP-1 RA. 

One way GLP-1 RAs work is to slow the stomach emptying rate.

The slower rate prevents high blood sugar levels after meals and increases fullness, leading to weight loss. 

Food and drinks stay in the stomach significantly longer when taking Ozempic.

None of the clinical trials state how much slower the stomach empties. 

However, one small study on 20 women taking Ozempic found that 37% of the solid meal was still present in the stomach four hours after a meal.

Women not taking Ozempic retained no portion of their meal four hours later. 

Heartburn can happen to any person when their stomach is too full for too long. 

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Increased Pressure on the Lower Esophageal Sphincter

There is a sphincter powered by a muscle between the esophagus and stomach that opens and closes to allow food into the stomach.

This lower esophageal sphincter doesn’t work as well when the stomach is full, leading to backflow up the esophagus (heartburn). 

With Ozempic, slower digestion can lead to food hanging around the stomach longer, increasing pressure on the sphincter and resulting in heartburn. 

The Ozempic side effect of burping causes the sphincter to open more often, contributing to heartburn. 

Excess weight can also put extra pressure on the abdomen and lower esophageal sphincter. 

Changes in Stomach Acid Levels

The body produces stomach acid in the presence of food in the stomach.

Stomach acid helps to digest food to make it usable for the body. 

Food sitting longer in the stomach, like what happens when taking Ozempic, could lead to different amounts of acid than someone not taking Ozempic.

In 2001, an acid pocket was first reported in the Gastroenterology publication.

After testing patients with heartburn, researchers discovered that the pH was 4 or 5 (acidic) in the stomach, 2 (very acidic) right below the lower esophageal sphincter. Then, the pH rose to 6 or 7 (almost neutral) in the esophagus. 

The area below the sphincter has a pocket of acid floating on top of the most recent meal.

This pocket of acid is thought to be gastric acid that hasn’t mixed properly with food and floats on top instead.

The researchers stated this can occur in all individuals but is especially troublesome for those with heartburn or reflux. 

If individuals taking Ozempic have undigested food longer than the average, this acid pocket may be present longer. 

Tips for Managing Heartburn While Taking Ozempic

There are several lifestyle changes and eating changes that can help you manage heartburn. Treatment for heartburn is no different while taking Ozempic. 

Lifestyle changes are considered first. Then, healthcare professionals look to medications to help manage heartburn. 

Lifestyle changes include:

  • Safe and healthy weight loss to reduce pressure on the abdomen and sphincter.
  • Avoid eating three to four hours before bedtime.
  • Maintain good sleep habits (undisturbed sleep correlates to decreased reflux episodes).
  • Elevate the head of the bed to prevent backflow of acid into the esophagus.
  • Diet modification can help reduce symptoms in some people. 

Some people find relief with diet changes.

‍Diet changes include eliminating caffeine, chocolate, spicy or fatty foods, citrus, and carbonated drinks. 

Researchers find that regular coffee and chocolate increase esophageal acid exposure.

Beer and wine increase heartburn mainly in the first hour after drinking. High-fat foods make reflux symptoms worse. 

There is less research on carbonated beverages and spicy foods causing heartburn.

‍Working with a dietitian can help you discover foods or lifestyle habits to relieve heartburn. 

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Remedies for Heartburn Relief

If you find yourself in the small percentage of people with heartburn while taking Ozempic, there are other steps to get relief. 

Non-Medicine Management of Heartburn

Many herbal remedies exist for treating heartburn.

Taking various forms or teas of ginger, chamomile, aloe vera, and licorice are some of the most common. 

There is research showing their effectiveness in reducing heartburn symptoms. 

However, some work by speeding up the digestion rate, while Ozempic is working on slowing the rate.

Speak with your healthcare provider before taking herbal remedies, as they may interact with your medications. 

Over-the-counter (OTC) Medicine Management of Heartburn

If heartburn is bothersome and not improving, your healthcare provider can recommend OTC medicines like antacids or H2 blockers such as Pepcid, Zantac, or Tagamet to help reduce side effects.

Your provider can help you determine the best medicines to try.

You should find relief from diet and lifestyle changes and the possible addition of OTC medicine. If you don’t, please seek out further help. 

Prevention Tips for Heartburn While Taking Ozempic

  1. Avoid eating within 3 hours of bedtime. 
  2. Eat more of your daily food before mid-afternoon to allow for digestion.
  3. Elevate the head of the bed by four to six inches.
  4. Lie on the left side instead of the right side while sleeping.
  5. Avoid tobacco use.
  6. Stay upright, especially after eating. 
  7. Increase physical activity to promote stomach motility if your stomach is too full. 
  8. Reduce or eliminate alcohol intake. 
  9. Avoid large, high-fat meals. 
  10. Chew your food well. 
  11. Aim for balanced meals with lean protein, fruits, vegetables, and fiber-rich carbohydrates. 
  12. Keep a food diary to identify any trigger foods. 
  13. Drink fluids separate from meals to reduce stomach fullness. 

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Takeaway

Heartburn affects about 2% of people taking Ozempic. Ozempic works by slowing digestion, which can sometimes cause heartburn. 

Making diet and lifestyle changes reduces the symptoms of heartburn.

If diet and lifestyle changes are ineffective, speak with your healthcare provider about additional heartburn treatment. 

How a Dietitian Can Help

A registered dietitian nutritionist can help you change your diet to relieve heartburn and help you with other tips to manage type 2 diabetes while taking Ozempic. 

Find a dietitian near you that accepts insurance using Nourish.

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Frequently Asked Questions

How do you stop acid reflux on Ozempic?

Give lifestyle and diet changes a chance to work.

They should start helping within one to two weeks. If reflux is persistent, seek advice from your healthcare provider.

Can semaglutide cause severe heartburn?

Clinical trials group all cases of heartburn. Only 2% of people taking Ozempic report heartburn as a side effect. 

Ozempic slows digestion, allowing you to stay full longer, reducing your appetite, and aiding weight loss. Slowed digestion can cause heartburn in some people.

‍

Does Ozempic cause chest discomfort?

Heartburn can feel like chest burning or pain.

Heart attacks tend to feel like squeezing, pressure, and tightness.

Other less common side effects of Ozempic include a slight 2 - 3 beat per minute heart rate increase, dizziness, and fatigue.

References

View all references
  1. What Is Ozempic®? | Ozempic® (semaglutide) Injection 0.5 mg or 1 mg. (n.d.).
  2. Nauck, M. A., Quast, D. R., Wefers, J., & Meier, J. J. (2021). GLP-1 receptor agonists in the treatment of type 2 diabetes - state-of-the-art. Molecular metabolism, 46, 101102.
  3. Wharton, S., Calanna, S., Davies, M., Dicker, D., Goldman, B., Lingvay, I., Mosenzon, O., Rubino, D. M., Thomsen, M., Wadden, T. A., & Pedersen, S. D. (2022). Gastrointestinal tolerability of once-weekly semaglutide 2.4 mg in adults with overweight or obesity, and the relationship between gastrointestinal adverse events and weight loss. Diabetes, obesity & metabolism, 24(1), 94–105.
  4. Jensterle, M., Ferjan, S., Ležaič, L., Sočan, A., Goričar, K., Zaletel, K., & Janez, A. (2023). Semaglutide delays 4-hour gastric emptying in women with polycystic ovary syndrome and obesity. Diabetes, obesity & metabolism, 25(4), 975–984.
  5. Antunes, C., Aleem, A., & Curtis, S. A. (2023). Gastroesophageal Reflux Disease. In StatPearls. StatPearls Publishing.
  6. Camilleri, M., Malhi, H., & Acosta, A. (2017). Gastrointestinal Complications of Obesity. Gastroenterology, 152(7), 1656–1670.
  7. Boeckxstaens G. (2013). The Relationship Between the Acid Pocket and GERD. Gastroenterology & hepatology, 9(9), 595–596.
  8. Schulz, R. M., Ahuja, N. K., & Slavin, J. L. (2022). Effectiveness of Nutritional Ingredients on Upper Gastrointestinal Conditions and Symptoms: A Narrative Review. Nutrients, 14(3), 672.
  9. Ali, R. A. R., Hassan, J., & Egan, L. J. (2022). Review of recent evidence on the management of heartburn in pregnant and breastfeeding women. BMC gastroenterology, 22(1), 219.
Nourish has strict sourcing policies and prioritizes primary sources, including medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about our medical review process and editorial guidelines.

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California
,
Anaheim
, 
CA
California
33.836594, -117.914299
Springfield
, 
MO
Missouri
37.208958, -93.292297
Fort Wayne
, 
IN
Indiana
41.077469, -85.137489
Phoenix
, 
AZ
Arizona
33.448376, -112.074036
Bakersfield
, 
CA
California
35.3738712, -119.0194639
Garden Grove
, 
CA
California
33.774269, -117.937996
Anchorage
, 
AK
Alaska
61.2163129, -149.894852
Indianapolis
, 
IN
Indiana
39.768402, -86.158066
Nashville
, 
TN
Tennessee
36.162663, -86.781601
Tempe
, 
AZ
Arizona
33.425522, -111.941254
Mobile
, 
AL
Alabama
30.695366, -88.039894
New Orleans
, 
LA
Louisiana
29.951065, -90.071533
Knoxville
, 
TN
Tennessee
35.960636, -83.920738
Grand Rapids
, 
MI
Michigan
42.963360, -85.668083
Fontana
, 
CA
California
34.102890, -117.435760
Elk Grove
, 
CA
California
38.418129, -121.393257
Miami
, 
FL
Florida
25.7825389, -80.3118603
Grand Prairie
, 
TX
Texas
32.745499, -97.003532
Fort Collins
, 
CO
Colorado
40.588970, -105.082458
Killeen
, 
TX
Texas
31.117119, -97.727798
Modesto
, 
CA
California
37.639095, -120.996880
Oklahoma City
, 
OK
Oklahoma
35.468491, -97.521263
Santa Ana
, 
CA
California
33.745571, -117.867836
Ontario
, 
CA
California
34.063343, -117.650887
Brownsville
, 
TX
Texas
25.9015688, -97.4984005
Montgomery
, 
AL
Alabama
32.379223, -86.307739
Hialeah
, 
FL
Florida
25.857595, -80.278107
Springfield
, 
MA
Massachusetts
42.102051, -72.585762
Toledo
, 
OH
Ohio
41.652805, -83.537865
Pembroke Pines
, 
FL
Florida
26.007765, -80.296257
Overland Park
, 
KS
Kansas
38.974819, -94.683601
Little Rock
, 
AR
Arkansas
34.746483, -92.289597
Glendale
, 
CA
California
34.142509, -118.255074
Roseville
, 
CA
California
38.752125, -121.288010
Rancho Cucamonga
, 
CA
California
,
Wichita
, 
KS
Kansas
37.687176, -97.330055
Huntington Beach
, 
CA
California
33.659485, -117.998802
Augusta
, 
GA
Georgia
33.4709714, -81.9748429
Worcester
, 
MA
Massachusetts
42.271389, -71.798889
Virginia Beach
, 
VA
Virginia
36.852924, -75.977982
Oceanside
, 
CA
California
33.1958696, -117.3794834
Santa Clarita
, 
CA
California
34.456043, -118.571335
Philadelphia
, 
PA
Pennsylvania
39.952583, -75.165222
Corpus Christi
, 
TX
Texas
27.800583, -97.396378
Portland
, 
OR
Oregon
45.512230, -122.658722
Denver
, 
CO
Colorado
39.739235, -104.990250
Boston
, 
MA
Massachusetts
42.3554334, -71.060511
Atlanta
, 
GA
Georgia
33.7489924, -84.3902644
Chicago
, 
IL
Illinois
41.8755616, -87.6244212
Orlando
, 
FL
Florida
28.538336, -81.379234
Jacksonville
, 
FL
Florida
30.332184, -81.655647
Tampa
, 
FL
Florida
27.950575, -82.457176
Long Island
, 
NY
New York
40.757801, -73.940033
Queens
, 
NY
New York
40.728226, -73.794853
Bronx
, 
NY
New York
40.8466508, -73.8785937
Staten Island
, 
NY
New York
40.643501, -74.076202
Brooklyn
, 
NY
New York
40.6526006, -73.9497211
New York
, 
NY
New York
40.712776, -74.005974
San Jose
, 
CA
California
37.342205, -121.851990
San Francisco
, 
CA
California
37.774929, -122.419418
San Diego
, 
CA
California
32.834686, -117.130775
Los Angeles
, 
CA
California
34.052235, -118.243683
El Paso
, 
TX
Texas
31.761877, -106.485023
San Antonio
, 
TX
Texas
29.387428, -98.496574
Dallas
, 
TX
Texas
32.776665, -96.796989
Fort Worth
, 
TX
Texas
32.755489, -97.330765
Houston
, 
TX
Texas
29.760427, -95.369804
Austin
, 
TX
Texas
30.2711286, -97.7436995
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