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Serious side effects Although rare, some people taking Rybelsus or Ozempic may experience: Severe allergic reaction Kidney problems Gallbladder problems Low blood sugar (hypoglycemia) Pancreatitis (inflammation of the pancreas) Diabetic retinopathy in patients with Type 2 Diabetes Thyroid tumors, including medullary thyroid carcinoma, a rare but serious condition Warnings Both drugs have a black box warning from the FDA for the risk of thyroid tumors or thyroid cancer