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Common Side Effects (Both Oral and Injectable): Gastrointestinal Issues: These are the most common side effects for all GLP-1 medications: Nausea: Oral semaglutide (Rybelsus): 11-20% of patients Injectable semaglutide (Wegovy): 44% of patients Injectable tirzepatide (Zepbound): 30-37% of patients Why the difference: Lower bioavailability of oral medication means less systemic exposure, potentially resulting in fewer GI side effects

Summary: GLP-1 receptor agonists are not recommended during breastfeeding due to insufficient safety data on excretion into breast milk and potential effects on nursing infants

10.1016/j.ejmech.2017.07.046 75

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