Rybelsus (Semaglutide) Associated With Significantly Increased Risk Of Blood Clots

(Posted by Tom Lamb at Drug Injury Watch)

In this post, we point out a recent medical journal article that discusses a Rybelsus deep vein thrombosis case report. We have been investigating possible drug injury lawsuits involving Ozempic, Wegovy, and Rybelsus deep vein thrombosis side effects.

Ozempic, Wegovy, and Rybelsus are relatively new medications from Novo Nordisk that have semaglutide as their active ingredient. The severe blood clots side effects of Ozempic, Wegovy, and Rybelsus, deep vein thrombosis (DVT) and pulmonary embolism (PE), are not as well-known as the gastrointestinal and stomach side effects, such as gastroparesis, or the eye-related side effects, such as NAION vision loss linked to Ozempic, Wegovy, and Rybelsus.

Starting as far back as 2021, however, Ozempic, Wegovy, and Rybelsus — the three Novo Nordisk semaglutide-containing drugs — had been associated with a significantly increased risk of blood clots.

As background, here is an excerpt from an earlier medical journal article, “Comprehensive analysis of the safety of semaglutide in type 2 diabetes: a meta-analysis of the SUSTAIN and PIONEER trials“, published by the Endocrine Journal back in 2021, that sets the stage for this Rybelsus deep vein thrombosis case report that we are pointing out today:

The PIONEER and SUSTAIN serial trials are designed to assess the efficacy outcomes with semaglutide in patients with type 2 diabetes, but are not powered to assess various safety outcomes. We sought to assess the risk of semaglutide in leading to various serious adverse events (SAEs) in patients with type 2 diabetes…. emaglutide versus control significantly reduced total SAEs (RR 0.92, 95% CI 0.87–0.97; I2 = 0) and atrial fibrillation (RR 0.69, 95% CI 0.50–0.95; I2 = 0), but significantly increased deep vein thrombosis (RR 3.66, 95% CI 1.09–12.25; I2 = 0) and diarrhoea (RR 2.66, 95% CI 1.19–5.95; I2 = 0). [Emphasis added.]

A teenage boy who was overweight and with sedentary behavior is the subject of this January 5, 2026, medical journal article, “Deep Venous Thrombosis Within Two Weeks of Initiating Oral Semaglutide (Rybelsus): A Case Report.” From the Abstract part of this article:

We report the case of a 16-year-old male with mild conventional risk factors for thrombosis [overweight body mass index (BMI) and prolonged sedentary behavior] who developed acute left lower extremity deep venous thrombosis (DVT) within two weeks of initiating oral semaglutide (Rybelsus, 7 mg daily) for weight reduction without medical supervision. He presented with progressive leg pain and swelling, and duplex ultrasonography revealed thrombosis of the distal superficial femoral and popliteal veins. An extensive thrombophilia workup, including cardiolipin and β2-glycoprotein antibodies, returned negative.Anticoagulation with low molecular weight heparin followed by apixaban resulted in significant clinical improvement.

This case suggests a possible association between oral semaglutide and venous thrombosis in an adolescent, highlighting the need for careful supervision during off-label use. Possible contributing mechanisms include hemoconcentration from gastrointestinal adverse effects, interaction with sedentary behavior, and potential effects of GLP-1RAs on coagulation or endothelial function. Similar cases have been described with injectable semaglutide and other GLP-1RAs, but limb DVT associated with oral semaglutide has not previously been reported.

We have written previously about deep vein thrombosis (DVT) and pulmonary embolism (PE) as blood clots side effects of Ozempic, Wegovy, and Rybelsus:

• No Warnings About Blood Clots From Ozempic, Wegovy, and Rybelsus in Drug Labels (7/18/24)
• Wegovy, Rybelsus, and Ozempic Blood Clots Cases Are Not Part of Federal Court MDL at This Time (5/14/24)
• “New” Blood Clots Side Effect of Semaglutide Weight Loss Drugs Like Ozempic: Deep Vein Thrombosis (2/22/24)

We can assist you or someone you know with an Ozempic, Wegovy, or Rybelsus deep vein thrombosis (DVT) case or pulmonary embolism (PE) case. One way to do this is to submit an online Case Evaluation Form.

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