Wegovy (semaglutide 2.4 mg) is a GLP-1 receptor agonist licensed for chronic weight management in the UK, with a well-established side effect profile predominantly involving gastrointestinal symptoms. Some patients wonder whether Wegovy causes urinary tract infections (UTIs), particularly if they develop urinary symptoms during treatment. This article examines the clinical evidence regarding any link between Wegovy and UTIs, explores why urinary symptoms may occur during treatment, and provides guidance on recognising UTI symptoms, when to seek medical advice, and practical strategies to reduce infection risk whilst taking this medication.

Understanding Wegovy and Its Common Side Effects

Wegovy (semaglutide 2.4 mg) is a glucagon-like peptide-1 (GLP-1) receptor agonist licensed by the MHRA for chronic weight management in adults with obesity or overweight with weight-related comorbidities. Administered as a once-weekly subcutaneous injection, Wegovy works by mimicking the naturally occurring hormone GLP-1, which regulates appetite and food intake. The medication slows gastric emptying, enhances satiety signals to the brain, and reduces hunger, thereby facilitating calorie reduction and sustainable weight loss.

In the UK, NICE recommends Wegovy for use within specialist weight management services for adults who meet specific eligibility criteria. Clinical trials have established a well-characterised side effect profile for Wegovy, with the majority of adverse effects relating to the gastrointestinal system. The most commonly reported side effects include:

• Nausea and vomiting – particularly during dose escalation

• Diarrhoea or constipation – affecting bowel regularity

• Abdominal pain and bloating – related to delayed gastric emptying

• Dyspepsia – indigestion or upper abdominal discomfort

• Headache – especially during initial treatment

• Fatigue and dizziness – especially in the initial treatment phase

• Injection site reactions – such as redness or irritation

These gastrointestinal effects typically diminish over time as the body adjusts to the medication. The gradual dose escalation schedule per the SmPC is specifically designed to improve tolerability. Less common but clinically significant side effects include gallbladder disorders (cholecystitis, cholelithiasis), pancreatitis, and hypoglycaemia (mainly when used alongside insulin or sulfonylureas in people with type 2 diabetes).

Patients should be counselled about expected side effects before initiating treatment and advised to report persistent or severe symptoms to their healthcare professional. Understanding the established safety profile of Wegovy helps patients distinguish between anticipated medication effects and symptoms that may warrant further investigation, such as urinary tract infections.

If you experience any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in the package leaflet. You can also report side effects directly via the MHRA Yellow Card scheme at yellowcard.mhra.gov.uk or via the Yellow Card app.

Does Wegovy Cause UTIs? Examining the Evidence

There is no established causal link between Wegovy and urinary tract infections (UTIs) based on current clinical evidence. Urinary tract infections are not listed among the recognised adverse effects in the Summary of Product Characteristics (SmPC) for Wegovy, nor were they identified as a significant safety signal in the pivotal STEP (Semaglutide Treatment Effect in People with obesity) clinical trial programme involving over 4,500 participants.

It is important to distinguish Wegovy from other diabetes medications where urinary tract issues are a documented concern. SGLT2 inhibitors (sodium-glucose co-transporter-2 inhibitors) such as dapagliflozin and empagliflozin are associated with increased risk of genital mycotic infections and, to a lesser and more variable extent, UTIs. This occurs because they increase urinary glucose excretion, creating a favourable environment for bacterial and fungal growth. Wegovy, as a GLP-1 receptor agonist, operates through an entirely different mechanism and does not alter urinary glucose levels in the same manner.

No MHRA safety signals have been issued regarding UTIs with Wegovy, and the European Medicines Agency's assessment did not identify UTIs as a treatment-related adverse effect. However, individual case reports may exist, and it remains theoretically possible for any medication to be associated with idiosyncratic reactions in susceptible individuals.

The absence of evidence for a direct causal relationship does not mean patients taking Wegovy cannot develop UTIs—rather, any UTIs that occur are likely coincidental or related to other risk factors rather than the medication itself. Women taking Wegovy for weight management may have pre-existing risk factors for UTIs, including diabetes, or anatomical factors, which are independent of the medication. Healthcare professionals should evaluate UTI symptoms on their clinical merits rather than automatically attributing them to Wegovy therapy.

Why UTI Symptoms May Occur During Wegovy Treatment

While Wegovy does not directly cause UTIs, several factors may explain why some patients experience urinary symptoms or develop infections during treatment. Understanding these mechanisms helps distinguish between medication effects and genuine urinary tract pathology.

Dehydration from gastrointestinal side effects represents a plausible indirect mechanism. Wegovy commonly causes nausea, vomiting, and diarrhoea, particularly during the initial weeks of treatment. These symptoms can lead to reduced fluid intake and increased fluid losses, resulting in dehydration. Concentrated urine and reduced urinary frequency create conditions that may increase susceptibility to bacterial colonisation of the urinary tract. Adequate hydration is essential for maintaining normal urinary flow, which helps flush bacteria from the bladder.

Some patients may experience changes in their overall health status during Wegovy treatment. As patients lose weight, their metabolic parameters often improve, which may influence various bodily systems. Additionally, improved glycaemic control in patients with type 2 diabetes may alter their previous patterns of urinary symptoms.

Coincidental timing must also be considered. UTIs are extremely common, particularly in women, with approximately 50–60% experiencing at least one UTI during their lifetime according to NICE Clinical Knowledge Summaries. The statistical likelihood of developing a UTI during a several-month course of Wegovy treatment is substantial, regardless of medication use. Other independent risk factors that may be present in patients taking Wegovy include:

• Female anatomy and sexual activity

• Pre-existing diabetes or impaired glucose tolerance

• Difficulties with perineal hygiene or skin folds

• Menopausal status and oestrogen deficiency

• Urinary retention or incomplete bladder emptying

Patients experiencing urinary symptoms should be evaluated for these alternative explanations rather than assuming a medication-related cause.

When to Seek Medical Advice About UTI Symptoms

Patients taking Wegovy should be aware of UTI symptoms and understand when medical assessment is necessary. Early recognition and appropriate treatment of UTIs prevent complications such as pyelonephritis (kidney infection) or, rarely, urosepsis.

Classic UTI symptoms requiring GP consultation include:

• Dysuria – pain, burning, or stinging during urination

• Urinary frequency and urgency – needing to urinate more often with sudden, compelling urges

• Suprapubic pain or discomfort – lower abdominal tenderness

• Cloudy, dark, or offensive-smelling urine

• Haematuria – visible blood in the urine

• Incomplete bladder emptying – sensation of residual urine after voiding

Patients should contact their GP practice within 24–48 hours if they experience these symptoms. In the UK, diagnosis is often symptom-led, particularly in women with typical presentations. While urine dipstick tests may be used, they are less reliable in older adults, people with catheters, and those with atypical symptoms. A midstream urine culture may be sent if indicated to guide antibiotic selection according to local antimicrobial resistance patterns.

Urgent same-day assessment or emergency care is warranted if:

• Fever above 38°C with rigors or shaking chills

• Loin pain or flank tenderness – suggesting upper urinary tract involvement

• Severe systemic symptoms – confusion, severe malaise, or vomiting

• Inability to tolerate oral fluids – due to persistent vomiting

• Visible haematuria with clots – indicating significant bleeding

These features may indicate pyelonephritis or complicated UTI requiring urgent medical evaluation and possible hospital admission for intravenous antibiotics. Certain groups should seek prompt assessment for suspected UTIs, including pregnant women, men, children, people with catheters, those with immunosuppression, and older adults with frailty. Call NHS 111 or 999 if you develop signs of sepsis such as extreme shivering, severe breathlessness, or mottled skin.

Persistent or unexplained visible blood in the urine requires follow-up according to NICE suspected cancer referral guidelines, even after a UTI has been treated.

Patients should not discontinue Wegovy based solely on UTI symptoms without consulting their prescribing clinician. UTIs are treatable conditions that do not typically require medication cessation. However, if recurrent UTIs develop (defined as ≥2 in 6 months or ≥3 in 12 months), further investigation may be warranted to identify underlying predisposing factors.

Reducing Your Risk of UTIs While Taking Wegovy

Patients taking Wegovy can adopt several evidence-based strategies to minimise their risk of developing urinary tract infections, regardless of whether the medication plays any role.

Maintain optimal hydration throughout Wegovy treatment. Aim for 1.5–2 litres of fluid daily (approximately 6–8 glasses), unless medically contraindicated. If you have heart, kidney or liver disease, discuss appropriate fluid intake with your healthcare professional. Adequate hydration ensures regular urination and dilute urine, which helps flush bacteria from the urinary tract. This is particularly important if experiencing gastrointestinal side effects from Wegovy. Water is the preferred fluid choice; limit caffeine and alcohol, which have diuretic effects.

Practice good urogenital hygiene:

• Wipe from front to back after using the toilet to prevent bacterial transfer from the rectal area

• Urinate soon after sexual intercourse to flush out any bacteria introduced during activity

• Consider breathable cotton underwear for comfort

• Empty your bladder completely when urinating; don't rush or hover over toilet seats

Manage Wegovy side effects effectively to prevent dehydration. Use anti-emetic medications if prescribed for nausea, eat smaller frequent meals, and report persistent gastrointestinal symptoms to your healthcare professional. Following the recommended dose escalation schedule reduces the likelihood of severe side effects.

Address underlying risk factors where possible. For postmenopausal women experiencing recurrent UTIs, discuss vaginal oestrogen therapy with your GP, as oestrogen deficiency increases susceptibility. Optimise diabetes control if applicable, as elevated blood glucose can increase infection risk. Some people find cranberry products helpful, though evidence for prevention is modest and they may interact with warfarin – discuss with your pharmacist or GP if you're considering these supplements.

Avoid delaying urination when you feel the urge. Holding urine for prolonged periods allows bacterial multiplication in the bladder. Regular, complete bladder emptying is a simple but effective preventive measure that should be maintained throughout Wegovy treatment and beyond.

For those experiencing recurrent UTIs, speak with your GP about additional preventive strategies, which might include non-antibiotic options such as methenamine hippurate in appropriate cases.

Frequently Asked Questions