EffectCommonUncommonRareUnknown
Increased appetiteThe most frequent side effect in the 2-year older-adult trial; it eased over a few months.Common
Higher fasting glucose, HbA1c and insulin resistanceTested in people. Over a year in healthy older adults, fasting glucose rose about 5 mg/dL and HbA1c 0.2 points on MK-677 while neither rose on placebo; in hip fracture patients glucose rose 8.0 mg/dL vs a 1.6 mg/dL fall on placebo; in obese men fasting glucose held steady but a glucose tolerance test got worse; in the Alzheimer's trial 15.4 percent on MK-677 had a glucose rise vs 4.6 percent on placebo, and 11.1 vs 1.4 percent an HbA1c rise.Common
Fluid retention and leg swellingMild, transient lower-leg edema in the older-adult trial; FDA lists edema and fluid overload among its safety concerns.Common
Muscle and joint painMyalgia and arthralgia were more frequent than placebo in hip fracture and older-adult trials.Common
Raised cortisol and prolactinCortisol rose about 47 nmol/L over a year in older adults; prolactin rose about 23 percent but stayed in range in shorter studies.Common
Weight gainBody weight rose 2.7 kg vs 0.8 kg on placebo over 12 months in older adults, including more limb fat.Common
Congestive heart failure4 of 62 (6.5 percent) on MK-677 vs 1 of 61 on placebo in frail hip fracture patients, which ended the trial early; systolic blood pressure also rose about 12 to 16 mmHg on MK-677 in that trial (FDA 2024 briefing).Uncommon
Liver enzyme elevationsListed by FDA among adverse events leading to discontinuation across trials.Uncommon