Is It A Cold...Or Did You Just Start Ozempic?
There has been a ton of chatter online about the side effects of Ozempic that extend beyond what’s on the label. But while "Ozempic face" and "Ozempic butt" have gotten plenty of attention, there’s one potential side effect of Ozempic users keep talking about that’s more subtle: a runny nose.
Reddit is packed with stories from people who claim they developed a runny nose or postnasal drip after starting Ozempic. “I just took my first 0.5 [milligram] shot last night and within 20 minutes it started,” one user wrote. “Did not have this side effect at all after a month on 0.25 [milligrams]. I hope it subsides, very annoying.”
Another wrote, “I never had postnasal drip—certainly not this extreme before—so [I'm] wondering if it's the Ozempic.”
It’s easy to brush the issue off as a weird coincidence (and it may just be that—as you'll learn later!). But some doctors who prescribe Ozempic—a semaglutide medication that's technically approved for blood sugar control in people with type 2 diabetes but is prescribed off-label for weight loss—say there’s a possible connection between weight loss medications and developing a runny nose. “There’s definitely a mechanism behind this,” says Kunal Shah, MD, an assistant professor in the division of endocrinology at the Rutgers Robert Wood Johnson Medical Center.
Here’s what’s behind this side effect, plus what to do if you’re struggling with it.
Meet the experts: Alexandra Sowa, MD, is an internal medicine doctor specializing in preventative health, nutrition, and obesity medicine and the author of the forthcoming book The Ozempic Revolution. Kunal Shah, MD, is an an assistant professor in the division of endocrinology at the Rutgers Robert Wood Johnson Medical Center.
There are few possible reasons why you might notice a runny nose after going on Ozempic.
The first is that your runny nose may actually have to do with a virus, says Alexandra Sowa, MD, author of the upcoming book The Ozempic Revolution. COVID-19 is always circulating, and it’s also cold and flu season—and those viruses don’t magically stay away once you go on Ozempic. So, with that, you may have caught a cold or some other upper respiratory virus when you started taking Ozempic, so keep that in mind.
Another consideration: You may be more aware of your body while you’re on the medication. After all, it's pretty well known at this point that many people have some side effects on Ozempic, and your prescribing doctor will also likely go over them with you. So, maybe your nose had already been more runny than usual and you just didn’t notice it until you started the medication and were hyperaware of what was happening in your body at the same time. “Two things can both be true—you have a runny nose and you're on Ozempic—and also be unrelated,” Dr. Sowa notes.
It’s also entirely possible that Ozempic use is directly related to the runny nose side effect.
“Typically, the reason why this happens on these [GLP-1 agonist] medications is that they can cause gastroesophageal reflux or worsen it,” Dr. Shah says.
Gastroesophageal reflux, commonly known as acid reflux, is a condition where the contents of the stomach travel back up into your esophagus. “The acid irritates the lining of your throat,” Dr. Shah says. That can cause postnasal drip and a runny nose, along with other symptoms like nausea, pain while swallowing, and hoarseness, he says.
Finally, the runny nose may be related to how your GLP-1 medication is stimulating an important nerve in your body called the vagus nerve, which is part of a nerve system that controls your digestion, heart rate, and immune system, Dr. Sowa says. The vagus nerve has GLP-1 receptors, and this group of meds targets GLP-1 receptors in the body. In turn, use of one of these drugs impacts the vagus nerve and, in turn, can lead to other bodily symptoms—including a condition known as vasomotor rhinitis, Dr. Sowa explains, which is characterized by cold- and allergy-like symptoms including congestion, runny nose, and sneezing.
The runny nose effect is not necessarily specific to Ozempic and other semaglutides (such as Wegovy).
Dr. Shah notes that it can also happen with tirzepatides like Zepbound and Mounjaro, among other medications in the class of drugs known as GLP-1 receptor agonists. For instance, experts know that “acid reflux happens with tirzepatide, so we can infer that people are probably at risk for runny nose with that as well,” he says.
Always discuss side effects with your doctor.
If you’re dealing with a constant postnasal drip or runny nose, and you’re confident that you don’t have a virus, see your primary care physician to get evaluated for acid reflux, Dr. Shah recommends. You can also try taking over-the-counter acid-reducing medications like famotidine with meals to see if that helps, he says.
But it’s unlikely that you’ll deal with this issue for too long. Most people stop having side effects within a few months, when they get to a maintenance dose (meaning, you’re at the same dose you plan to be on for a while), Dr. Sowa says.
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