6 known interactions • 2 major • 4 moderate • 0 minor
Always disclose all medications to your healthcare providers — prescription medicines, OTC medications, vitamins, and herbal supplements. This list may not include every possible interaction. Use our Medicine Interaction Checker to screen your complete medication list.
Potentially life-threatening or causing permanent damage. Avoid combination.
May worsen condition or require dose adjustment. Monitor closely.
Usually limited clinical effect. Manage with routine monitoring.
Insulin
Combined use markedly increases hypoglycemia risk.
Management: Reduce basal insulin by 20% or more when starting semaglutide; monitor glucose closely.
Other GLP-1 receptor agonists
Duplication of pharmacological class with no additional benefit and additive GI toxicity.
Management: Do not combine. Use one GLP-1 agonist at a time.
Sulfonylureas
Additive glucose lowering substantially raises hypoglycemia risk.
Management: Reduce or discontinue sulfonylurea at initiation; monitor blood glucose frequently.
Warfarin
Delayed gastric emptying may alter warfarin absorption; reported changes in INR.
Management: Monitor INR when initiating, escalating, or stopping semaglutide.
Oral contraceptives / levothyroxine
Slowed gastric emptying may reduce absorption of time-sensitive oral medications.
Management: Take critical oral drugs at least 1 hour before the weekly injection, or at a consistent time relative to the dose.
Alcohol
Alcohol can amplify GI side effects (nausea, vomiting) and may mask or exacerbate hypoglycemia when used with insulin.
Management: Advise patients to limit alcohol and monitor glucose if drinking.
Always ask your pharmacist about potential interactions with food, alcohol, and supplements specific to Ozempic. Some medicines have significant interactions with grapefruit juice, high-fat meals, dairy products, or vitamin K-rich foods.