The 4 gallbladder warning signs to watch on Ozempic

Pain in your upper stomach, yellowing of your skin or eyes, fever and clay-colored stools. Ozempic's label lists these as possible symptoms of gallbladder problems and says to tell your healthcare provider right away if you get any of them (Ozempic label, FDA). Below that, what Ozempic's own trials and a study of 562,566 people found about gallstones. Every number links to its source.

The short version

Tell your healthcare provider right away if you get pain in your upper stomach, yellowing of your skin or eyes, fever or clay-colored stools while on Ozempic. Its label lists these as possible symptoms of gallbladder problems (Ozempic label, FDA).
In Ozempic's trials against dummy shots, gallstones were reported in 1.5% of people on the 0.5 mg dose and 0.4% on the 1 mg dose, and in none of the people on dummy shots (Ozempic label, FDA).
In 562,566 adults with type 2 diabetes and obesity, people on Ozempic-type drugs had an 8% lower risk of gallstones within 1 year than people on another diabetes pill, about 10 against 12 in 1,000 (Ghusn, 2026).
Some studies link the other diabetes pills to gallbladder disease too, so this study can't show how Ozempic-type drugs compare with no drug (Ghusn, 2026).
People on semaglutide, the drug in Ozempic, had an 11% higher risk of gallstones than people on tirzepatide, the drug in Mounjaro (Ghusn, 2026) (Mounjaro label, FDA).

The 4 gallbladder warning signs to watch

Ozempic's US medication guide says gallbladder problems have happened in some people who take it, and tells them to tell their healthcare provider right away if they get symptoms of gallbladder problems, which may include (Ozempic label, FDA):

pain in your upper stomach (abdomen)
yellowing of your skin or eyes (jaundice)
fever
clay-colored stools

For doctors, the label says that if gallstones or an inflamed gallbladder are suspected, gallbladder tests and follow-up are called for (Ozempic label, FDA).

If you take a different medicine, ask your pharmacist which warnings apply to it.

What Ozempic's own trials found

The label says gallbladder problems such as gallstones and an inflamed gallbladder have been reported in trials of GLP-1 drugs and after they went on sale. In Ozempic's trials against dummy shots, gallstones were reported in 1.5% of people on 0.5 mg and 0.4% on 1 mg, and in none of the people on dummy shots (Ozempic label, FDA). These figures don't show that the 1 mg dose is safer, and they can't be compared directly with the study below, which used different people and methods.

The study of 562,566 people

Researchers used health records from more than 160 healthcare organizations. They took adults with type 2 diabetes and obesity who had at least two prescriptions for either an Ozempic-type drug (semaglutide or tirzepatide) or a DPP-4 pill (sitagliptin or linagliptin), another kind of diabetes pill, between 2020 and 2025. They left out people whose records showed past gallstones, gallbladder or bile duct disease, acute pancreatitis, or a removed or drained gallbladder. They matched 281,283 people in each group using age, sex, BMI, blood sugar (HbA1c) and other recorded risks, though BMI and blood sugar still differed after matching, and followed them for up to 1 year (Ghusn, 2026).

People with new gallstones within 1 year, out of 281,283 in each group.

Compared with people on a DPP-4 pill, people on Ozempic-type drugs had (Ghusn, 2026):

gallstones: 2,863 people against 3,275, 1.02% against 1.16%, an 8% lower risk (likely range 4% to 13% lower)
an inflamed gallbladder (cholecystitis): a 12% lower risk (likely range 2% to 21% lower), 653 people against 782
gallbladder removed or drained: a 49% lower risk (likely range 31% to 62% lower), 64 people against 132
acute pancreatitis, sudden inflammation of the pancreas: a 32% lower risk (likely range 24% to 39% lower), 590 people against 907

The risk percentages come from the study's hazard ratios, which allow for how long each person was followed, so they don't match the counts exactly. Not everyone was followed for the full year.

Semaglutide against tirzepatide

The same study compared 242,876 people on tirzepatide, the drug in Mounjaro (Mounjaro label, FDA), with 242,876 on semaglutide, the drug in Ozempic. Gallstones were found in 0.97% of people on tirzepatide and 1.06% on semaglutide, and people on semaglutide had an 11% higher risk of gallstones (likely range 5% to 18% higher) and a 22% higher risk of an inflamed gallbladder (likely range 10% to 37% higher). Acute pancreatitis and gallbladder removal didn't clearly differ (Ghusn, 2026). People on tirzepatide were followed for less time on average, about 274 days against 332, which the authors say can bias the comparison (Ghusn, 2026).

Where to start

If you're on Ozempic and get pain in your upper stomach, yellowing of your skin or eyes, fever or clay-colored stools, tell your healthcare provider right away.
On a different medicine, ask your pharmacist which warnings apply to it.

How far to trust these numbers

Both groups in the study of 562,566 people took a diabetes drug. The authors note that the other diabetes pills have themselves been linked to gallbladder disease in some studies, so the lower risk is a comparison with those pills and doesn't show that Ozempic-type drugs carry no gallbladder risk (Ghusn, 2026).
People weren't given a drug at random. After matching, the Ozempic-type group was still heavier, with an average BMI of 36.1 against 32.0, and had lower average blood sugar. Diet and how fast people lost weight weren't measured, and the records couldn't confirm that people kept taking the drug (Ghusn, 2026).
These are links seen in health records, so they don't show that Ozempic-type drugs prevent gallstones. People were followed for up to 1 year, so longer-term risk is uncertain. Diagnoses came from health record codes, which can miss or mislabel some (Ghusn, 2026).
Everyone in the study had type 2 diabetes and obesity, so the results may not apply to people taking these drugs for weight loss alone.

The 4 gallbladder warning signs to watch on Ozempic

The short version