Which of the following counselling points would be INCORRECT related to semaglutide?

• A. Gastrointestinal side effects such as nausea, vomiting and diarrhoea are rare, but in severe cases they can lead to complications including kidney damage resulting in hospitalisation.
• B. Semaglutide is often started at a low dose and titrated gradually to minimise GI side effects.
• C. It is contraindicated in patients with personal or family history of medullary thyroid carcinoma or MEN2.
• D. It can be used for weight loss and for long-term weight management.

Answer: (A)

Gastrointestinal adverse effects and how to manage them are central to counselling about semaglutide. These GI issues—nausea, vomiting and diarrhoea—are common, especially after starting treatment or increasing the dose, and they tend to lessen over time. Because of this, the usual approach is to start at a low dose and titrate gradually to minimise these effects.

It’s also important to recognise that dehydration from significant GI symptoms can, in theory, affect kidney function if it becomes severe, but kidney damage is not a typical or expected consequence of semaglutide’s GI side effects. Describing GI side effects as rare and stating they routinely cause kidney damage requiring hospitalisation overstates the risk and is not correct.

The other counselling points are accurate: semaglutide is contraindicated in individuals with personal or family history of medullary thyroid carcinoma or MEN2, and it can be used for weight loss and for long-term weight management in appropriate patients.