The most important serious side effects include acute pancreatitis (severe persistent abdominal pain radiating to the back, though clinical trials found similar pancreatitis rates to comparators), severe dehydration from persistent vomiting or diarrhea (signs include dizziness, decreased urination, extreme thirst), gallbladder disease including cholecystitis or cholelithiasis (right upper quadrant pain, fever, jaundice), severe allergic reactions (difficulty breathing, swelling of face or throat), and severe hypoglycemia when combined with insulin or sulfonylureas (confusion, loss of consciousness, seizures)
doi: 10.1080/19490976.2018.1441664 255 MarkleJGFrankDNMortin-TothSRobertsonCEFeazelLMRolle-KampczykUet al
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Arch Biochem Biophys 288: 653663 MerksamerPI,TrusinaA,PapaFR (2008) Realtime redox measurements during endoplasmic reticulum stress reveal interlinked protein folding functions
The behavioural and molecular effects last orders of magnitude longer