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Patients taking Ozempic should contact their GP or diabetes care team if they experience any of the following: Persistent mouth sores lasting longer than three weeks without improvement (this requires urgent referral to exclude oral cancer, as per NICE guideline NG12) [3] Recurrent ulceration with multiple episodes occurring in quick succession Large or unusually painful ulcers that interfere with eating, drinking, or speaking Ulcers accompanied by systemic symptoms such as fever, fatigue, weight loss, or night sweats Red or white patches in the mouth that do not resolve (these may require urgent referral) Lumps or swellings in the mouth that persist (these may require urgent referral) Difficulty swallowing or a sensation of food sticking in the throat Signs of oral infection including white coating on the tongue (possible thrush), severe pain, or foul taste Red flag symptoms that require urgent medical attention include severe pain unresponsive to simple analgesia, signs of dehydration (reduced urine output, dizziness, confusion), or any suspicion of a serious underlying condition

However, another 205-patient RCT reported that, although a minority of patients did experience an ALT rise with 4 g paracetamol daily, this rise resolved following further days of dosing [25]