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
Concurrent insulin substantially increases hypoglycemia risk.
Management: Reduce basal insulin dose by 20–30% when adding semaglutide; monitor glucose.
Other GLP-1 receptor agonists (liraglutide, dulaglutide, exenatide)
Combining semaglutide with another GLP-1 agonist duplicates the mechanism, adding GI toxicity without benefit.
Management: Contraindicated — never combine GLP-1 agonists.
Sulfonylureas (glipizide, glyburide, glimepiride)
Additive insulin secretagogue action raises hypoglycemia risk, particularly in fasting.
Management: Halve the sulfonylurea dose at initiation; titrate based on response.
Warfarin
Semaglutide's effect on gastric emptying can unpredictably alter warfarin absorption.
Management: Monitor INR frequently during dose titration and after reaching maintenance dose.
Oral contraceptives / levothyroxine
Delayed gastric emptying may reduce or delay oral drug absorption.
Management: Take time-sensitive oral medications at least 1 hour before the semaglutide injection day.
Alcohol
May worsen nausea and vomiting. Can also contribute to delayed gastric emptying.
Management: Advise limiting alcohol, especially during the dose-escalation phase.
Always ask your pharmacist about potential interactions with food, alcohol, and supplements specific to Semaglutide (Oral). Some medicines have significant interactions with grapefruit juice, high-fat meals, dairy products, or vitamin K-rich foods.