Ozempic (semaglutide) is a brand-name prescription drug used in the treatment of adults with Type 2 Diabetes. Its two primary functions are to regulate blood sugar and reduce the risks of major cardiovascular events in patients with both Type 2 Diabetes and cardiovascular diseases. Weight loss can be a side effect of Ozempic, and the drug is sometimes prescribed off-label for weight loss purposes.

Ozempic doesn’t contain insulin, but it does stimulate the natural pancreatic release of insulin. Known as a glucagon-like peptide 1 (GLP-1) receptor agonist, it communicates to various body systems that digestion is underway and thereby activates processes associated with the regulation of blood sugar. Ozempic also slows down gastric emptying (the rate at which food is emptied from the stomach into the small intestine) and the digestive process as a whole.

Like any medication, Ozempic can cause side effects and have issues when interacting with other medications, supplements, and products. Some such interactions can cause negative or even seriously dangerous consequences. Before starting Ozempic (or adding a new prescription or product when you’re already taking Ozempic), it’s crucial to disclose all your current medications, supplements, and substance-based habits to your healthcare provider.

Below, we’ll provide an overview of some of the most common pharmaceutical Ozempic interactions to be aware of. We’ll also look at some relevant information regarding interactions between Ozempic and alcohol, supplements, and herbs. As always, keep in mind that the information on the Bisonpharmacy.com website isn’t intended to replace medical advice. For specific questions about drug interactions, speak directly with your healthcare provider.

Insulin

It’s not unusual for patients with Type 2 Diabetes to take more than one medication simultaneously to help control their blood sugar. And, often, Ozempic is prescribed along with insulin.

While Ozempic is injected once weekly and typically only lowers your blood sugar in response to food, insulin is injected more frequently and lowers blood sugar even when you haven’t recently eaten.

For this reason, low blood sugar (hypoglycemia) is the primary risk of interactions between Ozempic and insulin. To mitigate the risk of low blood sugar, your healthcare provider may preemptively adjust your Ozempic and/or insulin dosage. They may also suggest checking your blood sugar level more frequently as your body gets used to the new combination of medications and adjust dosages accordingly as necessary.

Mild symptoms of hypoglycemia include dizziness, shakiness, anxiety, and sweating. Mild hypoglycemia can generally be mitigated with the consumption of carbohydrates followed by close monitoring of blood sugar levels. Severe low blood sugar symptoms can include confusion, loss of coordination, slurred speech, and blurred vision. Severe hypoglycemia is considered a medical emergency and should be responded to as such to avoid serious consequences.

No matter what, you should always remain vigilant and monitor your blood sugar closely when taking Ozempic in combination with insulin.

Sulfonylureas

Sulfonylureas are a category of Type 2 Diabetes medications taken orally. They include Glucotrol (glipizide), Amaryl (glimepiride), and more.

Like Ozempic, sulfonylureas stimulate the pancreas and the natural release of insulin. In addition, they assist the body in using insulin efficiently and effectively.

Unlike Ozempic, sulfonylureas stimulate the release of insulin whether or not food has been ingested. This means that sulfonylureas, in combination with Ozempic, may result in low blood sugar.

Your healthcare provider will help you mitigate the risks of hypoglycemia if you’re taking Ozempic and sulfonylurea concurrently.

Glinides

Glinides are yet another oral medication used in the treatment of Type 2 Diabetes. A common example is Starlix (nateglinide). Taken before every meal, glinides stimulate the release of pancreatic insulin quickly and for a short period of time.

The interaction between Ozempic and glinides is similar to that between Ozempic and sulfonylureas. The main risk is low blood sugar, which should be carefully monitored and treated as necessary. Dosage adjustments should be made accordingly.

Oral Medications

Oral medications are meant to be digested and absorbed at a standard, predictable rate. Because Ozempic slows gastric emptying (the emptying of stomach contents into the small intestine) and slows the process of digestion as a whole, it’s reasonable to consider the impact this may have on their efficacy.

While there is no clinical evidence to indicate that the absorption of oral medications is negatively impacted by Ozempic, it’s worth speaking to your healthcare provider about any oral medications you’re currently taking. They may wish to adjust the dosages or timing of medications accordingly, or simply monitor you closely for the first little while to see how your body reacts to the new combination of medications.

Other Ozempic Interactions to Be Aware Of

Beyond prescription medications, other treatments such as over-the-counter medicines, certain herbal supplements, and even alcoholic beverages may have possible interactions with Ozempic. While not an exhaustive list, here are some products to be aware of while on the drug:

Ozempic With Alcohol

While Ozempic does not have any known direct interactions with alcohol, it’s important to remember that alcohol may impact your blood sugar levels. Because Ozempic also impacts your blood sugar levels, there’s the potential for dysregulation to occur.

If you drink alcohol, even minimally, it’s important to let your doctor or pharmacist know. They’ll be able to advise you on what quantity of alcohol (if any) will be safe for you to consume while on Ozempic.

Ozempic With Supplements

As always, it’s best to disclose any and all supplements to your doctor, no matter how innocuous or irrelevant they may seem. There are currently no known interactions between Ozempic and any vitamins, but that doesn’t guarantee there won’t be any in the future.

Ozempic With Herbs

Herbal supplements such as gymnema, prickly pear, bitter melon, and fenugreek are known to impact blood sugar levels. For this reason, it’s important to talk to your healthcare provider about the risk they may pose in combination with Ozempic. Consult your doctor or pharmacist before starting any new herbal or natural supplements.

When To Contact Your Healthcare Provider

You should reach out to your healthcare provider whenever you have questions about Ozempic interactions. From other Diabetes medications to alcohol, oral medications and herbal supplements, many products can cause negative reactions and symptoms or decrease the efficacy of one or more of the drugs you’re taking concurrently with Ozempic.

In all likelihood, your doctor will carefully review any possible interactions with you before prescribing Ozempic along with other drugs, but it’s always smart to be well-informed and watchful. The most common result of interactions with Ozempic is low blood sugar, so it’s incredibly important to monitor your blood sugar levels closely, be prepared to react appropriately if any concerning trends appear, and contact your healthcare provider immediately in the event that they do.

When To Avoid Ozempic Altogether

Though your doctor is the only person who can tell you whether or not Ozempic is the right fit for you, it’s worth noting that people with certain conditions or propensities are generally not good candidates for the drug.

If you have a personal or family history of medullary thyroid cancer (MTC) or multiple endocrine neoplasia syndrome (MEN2), you will likely not be prescribed Ozempic. This is because rodent trials correlated an increased risk of these conditions with Ozempic (though the research has not been corroborated in humans).

In addition, if you’ve had a severe allergic reaction to any of the ingredients in Ozempic, your doctor likely won’t prescribe it for you.

See also: Ozempic and Pregnancy: Is It Safe?

Conclusion

To conclude, Ozempic is a non-insulin Type 2 Diabetes medication that can effectively regulate blood sugar levels and decrease the risks of major cardiovascular events in adults with Type 2 Diabetes and pre-existing cardiovascular conditions.

Like any medication, it can interact negatively with other prescription medications, supplements, or other types of products. Insulin, sulfonylureas, and glinides can all result in low blood sugar in combination with Ozempic, while oral medications may be digested and absorbed at different rates (and with potentially different outcomes) than expected.

Ultimately, it’s always best to disclose all medications and supplements to your doctor, monitor yourself carefully for any signs of negative interactions, and contact your healthcare provider immediately with any questions, concerns, or unexplained symptoms.

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About the Author

Ida Edlweiss Gumpal is a licensed Pharmacist and medical writer. She took her internships at Mercury Drug Corporation, Inc., a Hospital internship at De Vera Medical Center, Inc., and a Manufacturing internship at Philmed Laboratories, Inc. She has plans on attending medical school with the goal of specializing in Neurosurgery or Cardiothoracic surgery.