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Ozempic® and blood clots

Blood clots and Ozempic: not in its labels, two 2025 meta-analyses that disagree, common clot risk factors and the DVT and PE signs that need help now.

Published · Updated · Ozempic®: side effects by symptom · Written by the PepLabo editorial team

When to get help
Context and scope

Questions about GLP-1 medicines and blood clots usually follow a news story or a case shared online. This page looks at what the Ozempic® product information in the US, the EU and Canada says, what two 2025 analyses of randomised trials found, why their results differ, and the risk factors and warning signs that matter for anyone, whatever medicine they take.

Key takeaways 5
  • Venous blood clots do not appear in any Ozempic® product information [1][2][3].
  • A 2025 meta-analysis of 39 trials found a higher risk of DVT with GLP-1 medicines (odds ratio 1.64) but no clear rise in VTE overall [4].
  • Another 2025 meta-analysis of 27 placebo-controlled trials found no difference in VTE and a lower risk of PE (risk ratio 0.60) [5].
  • A large US veterans study linked GLP-1 use to fewer coagulation disorders than usual diabetes care [6].
  • Cleveland Clinic says to call a provider or go to the emergency room for DVT or PE symptoms without waiting [9].

The official documents

Each product information document was checked on 20 October 2026. None lists DVT, pulmonary embolism or venous thromboembolism (VTE, the umbrella term for both) as an adverse reaction, in trial tables or in post-marketing reports.

Venous blood clots in Ozempic® (semaglutide injection) product information
DocumentDVT, PE or VTENearest relevant content
US Prescribing Information, revised 05/2026 [1]Not listed in section 6.1 or 6.2Section 5.6 warns about dehydration after stomach side effects
EU summary of product characteristics, section 4.8 [2]Not listedSection 4.4 asks people to avoid fluid depletion
Canadian monograph, authorised 2026-07-13 [3]Not listedPost-market reports include dehydration

Two meta-analyses, two answers

A meta-analysis in the Journal of the American Heart Association pooled 39 randomised trials with 70,499 participants, comparing GLP-1 medicines with placebo or other diabetes drugs. Overall VTE showed a non-significant upward trend (odds ratio 1.19), but DVT on its own was significantly more frequent (odds ratio 1.64), about 25 extra events per 10,000 person-years. The excess was most marked in trials lasting longer than 18 months and in cardiovascular outcome trials, and there was no significant change in PE [4].

A meta-analysis in the Journal of Thrombosis and Haemostasis took 27 placebo-controlled trials with 84,003 patients. It found no significant difference in overall VTE (risk ratio 0.70), no significant difference in DVT (risk ratio 1.21) and a lower risk of PE (risk ratio 0.60). Median VTE rates were 1.1 per 1,000 patient-years on GLP-1 medicines and 2.5 on placebo [5].

Why the results differ and what they mean for Ozempic®

The two analyses used different sets of trials (one included active comparators, the other placebo only), different statistical models and different cut-off dates. Clots were rare in both, so a handful of events can move the result. Both pooled several GLP-1 medicines, including but not limited to semaglutide, so neither gives an Ozempic®-specific estimate.

Observational data add another angle. A 2025 Nature Medicine analysis of US veterans with diabetes found GLP-1 use associated with a lower risk of coagulation disorders compared with usual care [6]. Single case reports also exist, such as a woman with type 2 diabetes who developed a portal vein clot within six months of starting semaglutide and was later found to carry a gene change linked to clotting [7]. One case cannot show cause.

Possible links, and what is only proposed

From the label: Ozempic® can cause vomiting and diarrhoea, and section 5.6 links these to dehydration [1]. Cleveland Clinic lists drinking enough fluids, especially when travelling, among ways to prevent DVT [9]. Whether dehydration on Ozempic® raises clot risk has not been studied.

Proposed but unconfirmed: the JTH authors note that earlier observational data had suggested GLP-1 medicines might lower VTE risk, an effect their analysis of randomised trials did not confirm for VTE overall [5].

General background: clots form when blood flow slows, a vein is injured or the blood clots more readily, and the risk rises when several factors coincide [8].

Risk factors that matter for everyone

The CDC, Cleveland Clinic and MedlinePlus list the main risk factors for DVT and PE [8][9][10]:

  • Major surgery, especially of the abdomen, pelvis, hip or legs, fractures and severe muscle injury.
  • Long periods without moving: bed rest, a leg in a cast, or sitting for hours on a journey.
  • Oestrogen from contraceptives or hormone therapy, pregnancy and the months after giving birth.
  • Heart or lung disease, cancer and its treatment, and inflammatory bowel disease.
  • A previous clot, an inherited clotting disorder or a family history of clots.
  • Older age, overweight or obesity, and smoking.

What general sources suggest

Cleveland Clinic’s prevention advice is practical: move around as soon as you can after illness or surgery, exercise your calf muscles and get up regularly on long journeys, drink enough fluids at all times, use medicines or compression stockings after surgery if your provider prescribes them, and avoid tobacco [9]. CDC notes that risk climbs when several factors are present together, which is a reason to tell your care team about all of them before surgery or long travel [8].

None of these sources mentions Ozempic®. If you are planning surgery, the Ozempic® label separately asks you to tell your healthcare providers in advance because of a rare risk of inhaling stomach contents under deep sedation [1].

Ozempic® context

Ozempic® is a once-weekly injection approved for adults with type 2 diabetes; its label starts at 0.25 mg and increases in steps of at least four weeks [1]. Some of the trials in the meta-analyses above were cardiovascular outcome trials in people with diabetes and heart disease, a group that already carries a higher baseline risk, since heart disease is itself a clot risk factor [4][8]. If you have had a clot before, or take oestrogen, mention it when Ozempic® is being considered so your prescriber has the full picture.

Ozempic® is a registered trademark of Novo Nordisk A/S. PepLabo is not affiliated with or endorsed by Novo Nordisk.

When to get help

The signs and contact information below come from this article’s sourced guidance.

Emergency

  • Sudden shortness of breath, chest pain, coughing up blood, light-headedness or fainting

    Contact: Emergency services; these can be signs of a pulmonary embolism

    Cleveland Clinic [9]

  • Swelling of one leg or arm, with pain, warmth or red or discoloured skin

    Contact: Your provider right away or the emergency room

    Cleveland Clinic [9], MedlinePlus [10]

  • A sudden severe headache with vision changes, stroke-like symptoms or seizures

    Contact: Emergency services

    Cleveland Clinic [9]

  • Swelling of the legs, ankles or feet, or passing less urine

    Contact: Your doctor immediately, or emergency care

    MedlinePlus semaglutide page [11]

Today

  • Vomiting or diarrhoea that does not stop

    Contact: Your prescriber, because of the dehydration warning

    Ozempic® Medication Guide [1]

At your next appointment

  • A past clot, a clotting disorder, or oestrogen use, before starting Ozempic® or before surgery

    Contact: Your prescriber and surgical team

    CDC [8], Ozempic® label section 5.10 [1]

Questions

Does Ozempic® cause blood clots?

Blood clots are not listed in any Ozempic® product information [1][2][3]. Meta-analyses of GLP-1 trials disagree, one finding more DVT and the other fewer PEs, and neither is specific to Ozempic® [4][5].

Why do the two meta-analyses reach different conclusions?

They used different trials, comparators and statistical methods, and clots were rare in both, so small numbers of events can shift results [4][5].

Is long-haul travel riskier on Ozempic®?

Long periods of sitting raise clot risk for anyone [8]. Cleveland Clinic advises moving regularly and drinking enough fluids on journeys [9], which also matters if Ozempic® is causing vomiting or diarrhoea [1].

I use oestrogen-containing birth control. Does Ozempic® add to the risk?

The Ozempic® label does not address clots. Oestrogen-containing contraceptives are an established risk factor in their own right [8], so mention both to your prescriber.

I have surgery coming up. What should I mention?

Major surgery raises clot risk [8], and the Ozempic® label asks you to tell your providers about it before any procedure with anaesthesia or deep sedation [1]. Your surgical team can plan for both.

What are the warning signs of a clot?

Swelling, pain, warmth or redness in one leg or arm, or sudden breathlessness, chest pain or coughing up blood. Cleveland Clinic says not to wait for these to settle [9].