Wegovy Injection Site Reactions That Won't Go Away: When to Worry and What to Do

How common are injection site reactions with Wegovy?

The Wegovy label pools three randomized, double-blind, placebo-controlled trials in adults with obesity or overweight, up to 68 weeks, covering 2,116 people on Wegovy 2.4 mg weekly and 1,261 on placebo [1]. Injection site reactions were reported in 1.4% of the Wegovy group and 1% of the placebo group [1]. That is far below the gastrointestinal reactions in the same table: nausea 44% versus 16%, diarrhea 30% versus 16%, vomiting 24% versus 6% [1].

In those trials, 6.8% on Wegovy and 3.2% on placebo stopped treatment permanently for an adverse reaction, most often nausea, vomiting or diarrhea [1].

What the label flags as serious

The label's skin-related warning is hypersensitivity, not local irritation. A prior serious hypersensitivity reaction to semaglutide or to any excipient in Wegovy is a contraindication, and anaphylaxis and angioedema have been reported with Wegovy [1]. The hypersensitivity warning states that anaphylactic reactions and angioedema have been reported after approval and that Wegovy should be discontinued if one is suspected [1].

The one skin symptom the label describes as persisting

The label groups paresthesia, hyperesthesia, burning sensation, allodynia, skin burning sensation, pain of skin and sensitive skin under dysesthesia, reported by 2% on 2.4 mg versus 1% on placebo [1]. At 7.2 mg weekly, dysesthesia was reported by 22%, versus 6% on 2.4 mg and 0% on placebo; the label states that dysesthesia increases with dose and that 18% of the people affected on 7.2 mg had not recovered by the end of the trial [1]. The label describes dysesthesia as altered skin sensation such as burning or pain from touch, not as an injection site reaction.

Reporting a reaction that does not settle

The label does not give a time cutoff for a lingering lump or redness. It says suspected adverse reactions can be reported to Novo Nordisk or to FDA through MedWatch [1].