# Vomiting on GLP-1s: what the labels say, when it tends to show up, and how to track it

> GLP-1 vomiting is on every label: Wegovy 24%, Zepbound 8-13%, Saxenda 15.7%, Ozempic 5-9.2%. When it hits, what to log, and how to track it in Peppy.

Source: https://peppytracker.com/side-effects/vomiting/
Last updated: 2026-09-02

Vomiting is one of the most common GLP-1 side effects on the labels. Wegovy lists it at 24% versus 6% on placebo, Saxenda 15.7% versus 3.9%, Zepbound 8-13% by dose, Mounjaro 5-9%, and Ozempic 5-9.2%. The labels say most of it happens during dose escalation and eases over time. Log each episode with severity, timing and fluids, and line it up against shot days and step-ups.

## GLP-1 vomiting: what it is and who reports it

GLP-1 vomiting is the step past nausea that many people hope to skip and a good share do not. Semaglutide (Ozempic, Wegovy), tirzepatide (Mounjaro, Zepbound) and liraglutide (Saxenda) all slow gastric emptying, and every one of their labels lists vomiting as a common adverse reaction. It is second only to nausea on most of them, and it is one of the top reasons people in the trials stopped.

| Label | Vomiting (drug / placebo) |
| --- | --- |
| Wegovy 2.4 mg | 24% / 6% |
| Saxenda | 15.7% / 3.9% |
| Zepbound 5 / 10 / 15 mg | 8% / 11% / 13% vs 2% |
| Mounjaro 5 / 10 / 15 mg | 5% / 5% / 9% vs 2% |
| Ozempic 0.5 / 1 mg | 5% / 9.2% vs 2.3% |

The weight-management labels run higher than the diabetes labels, which fits the higher target doses. Wegovy's label says vomiting was the second most common reason for stopping (1.2% versus 0% on placebo), and Saxenda's lists it at 1.7% versus less than 0.1%. Compounded [Compounded Semaglutide](https://peppytracker.com/compounds/semaglutide-compounded/) and [Compounded Tirzepatide](https://peppytracker.com/compounds/tirzepatide-compounded/) carry no label of their own; the branded numbers are the reference point.

## When it tends to show up

The labels agree on timing. Ozempic's says "the majority of reports of nausea, vomiting, and/or diarrhea occurred during dose escalation." Mounjaro's and Zepbound's say the same and add "decreased over time." Wegovy's says gastrointestinal reactions "were most frequently reported during dosage escalation."

What people report on top of that: the worst days are usually the first two or three after a shot, and the worst weeks are the first one or two after each step-up. Vomiting that happens on a steady dose you have been on for months is a different pattern from vomiting in the week after moving from 0.5 mg to 1 mg, and a log tells them apart. Wegovy steps every four weeks, Zepbound at least four weeks apart, so those dates are the ones to circle.

Many people also report it is a meal-size problem. Eating past fullness when the stomach is emptying slowly is the common thread in the notes, which is why the note field matters as much as the score.

## What is worth logging

- **Severity, 1-5, daily.** A 1 is queasy with no vomiting; a 5 is repeated episodes and nothing staying down. Score the worst point of the day, at the same time each evening.
- **Number of episodes and rough time.** "Once, 2 pm, after lunch" is enough for the note.
- **Fluids.** Whether you kept water down. This is the detail your prescriber will ask about because of the kidney warning.
- **Days since your shot.** Log the shot in the same app and the offset is automatic.
- **The dose you were on.** Vomiting at 5 mg and vomiting at 10 mg are separate baselines.
- **Nausea, stomach pain and diarrhea alongside.** See [nausea](https://peppytracker.com/side-effects/nausea/), [stomach pain](https://peppytracker.com/side-effects/stomach-pain/) and [diarrhea](https://peppytracker.com/side-effects/diarrhea/). Three rows rising together after a step-up reads differently from one.

If you missed or delayed a shot because of it, log that too. The [missed-dose guide](https://peppytracker.com/guides/missed-glp-1-dose/) covers what each label says about timing.

## When to contact your prescriber

Vomiting on its own is expected on the label. The things beside it are not.

- **Persistent, severe abdominal pain, sometimes radiating to the back, with or without vomiting.** This is the pancreatitis warning on every GLP-1 label. Vomiting with that kind of pain is not a tracking question.
- **Signs of dehydration.** The labels note postmarketing reports of acute kidney injury and say "the majority of the reported events occurred in patients who experienced gastrointestinal adverse reactions leading to dehydration such as nausea, vomiting, or diarrhea." Dark urine, dizziness on standing, or not keeping fluids down for a day is a call. See [dehydration](https://peppytracker.com/side-effects/dehydration/).
- **Vomiting that does not settle after a step-up.** The labels say to consider delaying escalation if a dose is not tolerated. Your prescriber makes that call; the log makes it a short conversation.
- **Vomiting that starts months into a stable dose.** That is outside the escalation pattern the labels describe and worth a conversation.

## How to do this in Peppy

1. **Turn vomiting on.** The GLP-1 defaults are nausea, constipation, heartburn, sulfur burps and food noise. Open Settings ▸ Tracking and toggle Vomiting; Nausea and Dehydration sit in the same list.
2. **Score it in the daily check-in.** On the Today tab tap the check-in row. Set vomiting 1-5, write the episode count and fluids in the note, add weight if you weighed in. The check-in counts toward your streak.
3. **Log shots with the body map.** Tap the dose on the Today tab, tap the site on the silhouette, confirm the time. The dose is saved with it, so your titration ladder (Pro) becomes step-up markers on the charts.
4. **Read the heat-map in Progress (Pro).** The vomiting row sits next to nausea on the same week axis, with step-ups marked. If the row darkens for two weeks after each marker and then fades, that is the escalation pattern the labels describe. The free tier shows the chart blurred.
5. **Check the Calendar for the shot-day question.** The week strip shows shot days; flip through check-ins and compare day one after a shot with day five.
6. **Set a check-in reminder (Pro).** Settings ▸ Reminders adds a daily nudge so bad days do not go unlogged.
7. **Export before an appointment (Pro).** Settings ▸ Export produces a PDF or CSV of doses and check-ins. The [export guide](https://peppytracker.com/guides/export-dose-log-for-your-doctor/) covers what is in it.

Related: the [side-effects tracking guide](https://peppytracker.com/guides/track-glp-1-side-effects-food-noise/), the [titration schedule tracker](https://peppytracker.com/guides/glp-1-titration-schedule-tracker/), and the [Wegovy](https://peppytracker.com/trackers/wegovy-tracker/) and [Zepbound](https://peppytracker.com/trackers/zepbound-tracker/) tracker pages.

## Frequently asked

### How common is vomiting on GLP-1 medications?

It depends on the drug and dose. Wegovy's label lists vomiting in 24% of patients versus 6% on placebo. Saxenda lists 15.7% versus 3.9%. Zepbound lists 8%, 11% and 13% at 5, 10 and 15 mg versus 2%. Mounjaro lists 5%, 5% and 9% versus 2%. Ozempic lists 5% at 0.5 mg and 9.2% at 1 mg versus 2.3%.

### Does GLP-1 vomiting go away?

The labels say the majority of nausea, vomiting and diarrhea reports occurred during dose escalation and, for Mounjaro and Zepbound, decreased over time. They do not give a duration. Many people report it settles within a couple of weeks of each step-up, which is exactly what a daily log will show you.

### Is vomiting on Ozempic dangerous?

Occasional vomiting is expected on the label. The concern the labels raise is dehydration: they note postmarketing reports of acute kidney injury, most of them in patients whose nausea, vomiting or diarrhea led to dehydration. Repeated vomiting, dark urine or dizziness on standing is a reason to call your prescriber.

### Why does vomiting happen more after a dose increase?

The labels do not give a mechanism beyond noting that GLP-1 medicines slow gastric emptying. What they do say is that vomiting clusters during dose escalation. Wegovy's label says GI reactions were most frequently reported during dosage escalation, and Zepbound's says the same for nausea, vomiting and diarrhea.

### When should I call the doctor about vomiting on a GLP-1?

Every GLP-1 label flags persistent, severe abdominal pain that may radiate to the back, with or without vomiting, as possible pancreatitis. Vomiting that stops you keeping fluids down, or vomiting with signs of dehydration, is also a call-your-prescriber situation because of the kidney warning.

---

Peppy is a tracking tool, not medical advice. Dose calculations are mathematical conversions only. Always follow your prescriber's instructions and verify every draw-up yourself.

Peppy is a free iPhone app (Pro subscription optional). App Store: https://apps.apple.com/us/app/peptide-tracker-peppy/id6775005514