Does Wegovy cause migraines? Wegovy (semaglutide 2.4 mg) is a GLP-1 receptor agonist licensed in the UK for weight management in adults with obesity or overweight with weight-related comorbidities. Headache is a common side effect, affecting approximately 1 in 10 to 1 in 100 patients, particularly during initial dose escalation. However, the UK Summary of Product Characteristics does not specifically list migraine as an established adverse effect. This article examines the relationship between Wegovy and headaches, how to distinguish migraine from simple headache, and when to seek medical advice whilst taking this medication.

Does Wegovy Cause Migraines?

Wegovy (semaglutide 2.4 mg) is a glucagon-like peptide-1 (GLP-1) receptor agonist licensed in the UK for weight management in adults with obesity or overweight with weight-related comorbidities. According to the UK Summary of Product Characteristics (SmPC), headache is listed as a common adverse effect, occurring in approximately 1 in 10 to 1 in 100 patients. However, there is no specific mention of migraine in the SmPC, suggesting no established causal link between Wegovy and migraine specifically.

Headaches reported during Wegovy treatment are typically mild to moderate in severity and are commonly reported during the initial dose escalation phase. The exact mechanism behind these headaches is not fully established, though they may potentially relate to changes in blood glucose levels or alterations in gastric emptying. It is important to distinguish between tension-type headaches and true migraines, as the latter involve specific neurological features including unilateral throbbing pain, photophobia, phonophobia, and sometimes aura.

For individuals with a pre-existing history of migraine, there is currently insufficient evidence to suggest that Wegovy directly triggers or worsens migraine attacks. However, factors associated with weight loss therapy—such as dietary changes, dehydration, or altered eating patterns—may independently influence migraine frequency in susceptible individuals. The MHRA's Yellow Card scheme collects reports of headache as an adverse reaction to semaglutide products, though causality is not always confirmed.

Patients experiencing new or worsening headaches whilst taking Wegovy should maintain a symptom diary documenting headache characteristics, timing in relation to dosing, and potential triggers. This information assists healthcare professionals in determining whether symptoms represent a drug-related adverse effect, coincidental migraine, or another underlying condition requiring investigation.

Recognising Migraine Symptoms While Taking Wegovy

True migraine is a neurological condition characterised by recurrent episodes of moderate to severe headache, typically lasting 4 to 72 hours when untreated. Recognising the distinguishing features of migraine is essential for appropriate management, particularly when starting a new medication such as Wegovy.

Key features of migraine include:

• Unilateral location – pain affecting one side of the head, though it may be bilateral

• Pulsating or throbbing quality – distinct from the pressing sensation of tension headaches

• Moderate to severe intensity – sufficient to interfere with daily activities

• Aggravation by routine physical activity – such as walking or climbing stairs

• Associated symptoms – nausea, vomiting, photophobia (light sensitivity), and phonophobia (sound sensitivity)

Approximately one-third of migraine sufferers experience aura—transient neurological symptoms that typically precede the headache phase. Aura most commonly manifests as visual disturbances (zigzag lines, scotomas, or flashing lights) but may also include sensory changes (paraesthesia), speech difficulties, or motor symptoms. Aura symptoms develop gradually over 5 to 20 minutes and usually resolve within 60 minutes. New or atypical motor symptoms or unusual aura patterns warrant urgent medical assessment to exclude stroke.

When taking Wegovy, it is important to differentiate between simple headaches (which are often reported during dose escalation) and migraine. Simple headaches associated with GLP-1 receptor agonists are often reported as bilateral, mild to moderate, and typically resolve spontaneously without the characteristic associated features of migraine. If you have a known history of migraine, monitor whether your usual migraine pattern changes in frequency, severity, or character after starting Wegovy.

Maintaining a headache diary can help identify patterns, triggers, and the relationship between Wegovy dosing and symptom onset. Record the date, time, severity (using a 0–10 scale), location, quality of pain, associated symptoms, and any potential triggers such as missed meals, dehydration, or stress.

Managing Headaches and Migraines on Wegovy

Non-pharmacological strategies form the foundation of headache management for patients taking Wegovy. Ensuring adequate hydration is particularly important, as GLP-1 receptor agonists can cause gastrointestinal side effects including nausea and vomiting, which may lead to dehydration—a known migraine trigger. Aim for 6-8 glasses of fluid daily (approximately 1.2-1.5 litres), adjusting for activity level and climate.

Dietary considerations are equally important. Wegovy slows gastric emptying, which may alter eating patterns. Avoid prolonged fasting, as this can trigger headaches in susceptible individuals. Maintain regular, balanced meals and be mindful of common dietary migraine triggers such as aged cheeses, processed meats containing nitrates, alcohol (particularly red wine), and excessive caffeine or caffeine withdrawal.

Lifestyle modifications that support headache prevention include:

• Regular sleep patterns – aim for 7–9 hours nightly with consistent sleep and wake times

• Stress management – consider relaxation techniques, mindfulness, or cognitive behavioural approaches

• Regular physical activity – moderate exercise may reduce migraine frequency, though avoid overexertion during dose escalation

• Identifying and avoiding personal triggers – use your headache diary to recognise patterns

For acute headache relief, simple analgesics such as paracetamol (up to 1 g four times daily, maximum 4g in 24 hours) or ibuprofen (400 mg up to three times daily with food) are appropriate first-line options. Ibuprofen should be avoided if you have a history of stomach ulcers, kidney problems, or during pregnancy. Be aware that frequent use of pain relievers (more than 15 days per month) can lead to medication-overuse headache. If you have an established diagnosis of migraine and existing acute treatments (such as triptans), continue these as prescribed unless advised otherwise by your healthcare provider.

If headaches persist beyond the initial dose escalation phase or significantly impact quality of life, discuss with your prescriber whether temporarily pausing dose escalation might be appropriate. The Wegovy titration schedule is designed to minimise side effects, but individual tolerance varies. Some patients benefit from a slower escalation or remaining at a lower maintenance dose, as outlined in the product information.

Do not stop taking Wegovy without discussing with your prescriber, as this may affect your weight management plan and any associated metabolic benefits.

When to Seek Medical Advice About Wegovy Side Effects

Whilst mild headaches during Wegovy initiation are generally self-limiting, certain red flag features warrant prompt medical assessment. Seek urgent medical attention (contact 999 or attend A&E) if you experience:

• Sudden-onset severe headache ("thunderclap" headache reaching maximum intensity within seconds to minutes)

• Headache with fever, neck stiffness, or altered consciousness – potential signs of meningitis or encephalitis

• Headache following head trauma

• New neurological symptoms – weakness, visual loss, speech difficulties, or confusion

• Headache with features of raised intracranial pressure – worse on waking, aggravated by coughing or straining, associated with vomiting

Contact your GP or prescribing clinician within 24–48 hours if:

• Headaches are severe, persistent, or worsening despite simple analgesia

• You experience a significant change in your usual migraine pattern (increased frequency, severity, or different characteristics)

• Headaches are accompanied by persistent vomiting that prevents adequate hydration or medication absorption

• You develop visual disturbances not typical of your usual migraine aura

• Headaches significantly impair daily functioning or quality of life

If you are unsure how urgently to seek care, contact NHS 111 for advice.

Additionally, report any other concerning side effects of Wegovy, including severe, persistent abdominal pain (which may indicate pancreatitis), signs of gallbladder disease (such as upper right abdominal pain, fever, or yellowing of the skin/eyes), persistent nausea preventing adequate nutrition, or symptoms of hypoglycaemia (mainly a risk if taking insulin or sulfonylurea medications alongside Wegovy).

Your healthcare provider may recommend investigations such as blood pressure measurement (as hypertension can cause headaches), blood glucose monitoring, or consideration of other causes. In some cases, specialist referral to neurology may be appropriate for complex or refractory headache disorders.

All suspected adverse drug reactions can be reported via the MHRA Yellow Card scheme (yellowcard.mhra.gov.uk), contributing to ongoing pharmacovigilance and medication safety monitoring. Your prescriber can assist with this reporting process and will work with you to determine whether continuing Wegovy is appropriate or whether alternative weight management strategies should be considered.

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