The most common side effects of semaglutide are manageable gastrointestinal issues like nausea, vomiting, diarrhea or constipation. These tend to be mild-moderate and improve over a few weeks as your body adjusts. To minimize discomfort, inject it consistently around the same time daily with food and start with a low dose, gradually increasing. Less common side effects are gallbladder problems or worsening diabetic retinopathy. Alert your provider about vision changes or abdominal pain which could indicate complications.