Yes. Wegovy injection trials in adults found an average resting heart-rate increase of 1 to 4 beats per minute compared with placebo. An average is not a safety limit: some participants had larger changes, and persistent racing or pounding while resting should be reported. [1]
This article concerns the injection trial figures in the prescribing information. It does not assume every semaglutide formulation produces the same measured change. Our guide to GLP-1 drugs and arrhythmia addresses the separate question of abnormal heart rhythms.
What the larger pulse changes actually measure
In those adult trials, a maximum increase of at least 20 beats per minute at any visit occurred in 26% of Wegovy participants and 16% of placebo participants. That comparison describes each person's largest recorded change, not a sustained increase throughout treatment. [1]
These two measures answer different questions. The average describes the overall group shift; the maximum captures a person's highest observed change. Neither establishes the cause of a particular episode. A single smartwatch alert also cannot identify an arrhythmia.
Can a drug raise pulse and still protect the heart?
Those findings are compatible. In SELECT, 17,604 adults with established cardiovascular disease and overweight or obesity, but without diabetes, received semaglutide 2.4 mg or placebo. Major cardiovascular events occurred in 6.5% versus 8.0% over an average follow-up of about 40 months. [2]
The outcome combined cardiovascular death, nonfatal heart attack, and nonfatal stroke. It did not mean every participant benefited, nor that palpitations could be ignored. The population matters: these were people who already had cardiovascular disease. Our article on heart attack and stroke prevention examines how far those findings extend.
What to bring to your appointment
If you already monitor your pulse, record readings under comparable resting conditions. Include the time, symptoms, activity just beforehand, recent illness, and any medication changes. A short record of repeated symptoms is more informative than a screenshot of the highest number your watch has displayed.
Tell your clinician whether the sensation is steady racing, skipped beats, or pounding, and whether it occurs at rest. Ask whether you need an examination, rhythm tracing, or a review of other medications. This is a discussion about an individual symptom, not an instruction to achieve a particular watch reading.
The prescribing information calls for regular heart-rate monitoring and discontinuing Wegovy if a sustained increase in resting heart rate develops. That instruction belongs in a clinician-led assessment; it should not be replaced with an arbitrary online threshold. [1]
Symptoms that change the urgency
A fast or irregular heartbeat accompanied by fainting, chest discomfort, breathlessness, or marked dizziness needs urgent care. Do not use the small average increase as reassurance in that setting. MedlinePlus advises emergency assessment for dizziness with concerning cardiac symptoms. [3]
Fluid loss can also complicate the picture, especially after repeated vomiting or diarrhea. The dehydration warning signs and dizziness guide help you describe associated symptoms. They cannot determine which cause applies to you. Keep the focus on symptoms and clinical assessment rather than trying to explain every pulse change with the medication alone.