Semaglutide interactions

Food & lifestyle

• alcohol

  Moderate

  Synergy

  Alcohol may cause hypoglycemia or hyperglycemia in patients with diabetes. Hypoglycemia most frequently occurs during acute consumption of alcohol. Even modest amounts can lower blood sugar significantly, especially when the alcohol is ingested on an empty stomach or following exercise. The mechanism involves inhibition of both gluconeogenesis as well as the counter-regulatory response to hypoglycemia.

  What to do: Patients with diabetes should avoid consuming alcohol if their blood glucose is not well controlled, or if they have hypertriglyceridemia, neuropathy, or pancreatitis. Patients with well controlled diabetes should limit their alcohol intake to one drink daily for women and two drinks daily for men (1 drink = 5 oz wine, 12 oz beer, or 1.5 oz distilled spirits) in conjunction with their normal meal plan. Alcohol should not be consumed on an empty stomach or following exercise.

  9 sources

  1. Jerntorp P, Almer LO "Chlorpropamide-alcohol flushing in relation to macroangiopathy and peripheral neuropathy in non-insulin dependent diabetes." Acta Med Scand 656 (1981): 33-6
  2. Jerntorp P, Almer LO, Holin H, et al. "Plasma chlorpropamide: a critical factor in chlorpropamide-alcohol flush." Eur J Clin Pharmacol 24 (1983): 237-42
  3. Barnett AH, Spiliopoulos AJ, Pyke DA, et al. "Metabolic studies in chlorpropamide-alcohol flush positive and negative type 2 (non-insulin dependent) diabetic patients with and without retinopathy." Diabetologia 24 (1983): 213-5
  4. Hartling SG, Faber OK, Wegmann ML, Wahlin-Boll E, Melander A "Interaction of ethanol and glipizide in humans." Diabetes Care 10 (1987): 683-6
  5. "Product Information. Diabinese (chlorpropamide)." Pfizer U.S. Pharmaceuticals (2002):
  6. "Product Information. Glucotrol (glipizide)." Pfizer U.S. Pharmaceuticals (2002):
  7. "Product Information. Diabeta (glyburide)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  8. Skillman TG, Feldman JM "The pharmacology of sulfonylureas." Am J Med 70 (1981): 361-72

  Show all 9 sourcesShow fewer sources

  9. "Position Statement: evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes related complications. American Diabetes Association." Diabetes Care 25(Suppl 1) (2002): S50-S60

Conditions

Conditions in which Semaglutide needs care, as documented in this source.

• Mental Disorders

  Major

  The use of semaglutide (Wegovy) for weight loss should be avoided in patients with a history of suicidal attempts or active suicidal ideation. Suicidal behavior and ideation have been reported in clinical trials with other weight management products. If used, monitor patients for the emergence or worsening of depression, suicidal thoughts or behaviors, and/or any unusual changes in mood or behavior. Discontinue use in patients who experience suicidal thoughts or behaviors.

  1 source

  1. "Product Information. Wegovy (0.25 mg dose) (semaglutide)." Novo Nordisk Pharmaceuticals Inc (2021):

• Thyroid Neoplasms

  Major

  The use semaglutide is contraindicated in patients with a personal or family history of medullary thyroid carcinoma (MTC) or in patients with multiple endocrine neoplasia syndrome type 2 (MEN 2). Patients with elevated serum calcitonin or thyroid nodules noted on physical examination or neck imaging should be further evaluated. Counsel patients regarding the potential risk for MTC with the use of semaglutide and inform them of symptoms of thyroid tumors.

  1 source

  1. "Product Information. Ozempic (1 mg dose) (semaglutide)." Novo Nordisk Pharmaceuticals Inc (2022):

• Diabetic Retinopathy

  Moderate

  Semaglutide should be used with caution in patients with a history of diabetic retinopathy. Rapid improvement in glucose control has been associated with a temporary worsening of diabetic retinopathy. It is recommended to monitor closely for progression of diabetic retinopathy.

  1 source

  1. "Product Information. Ozempic (1 mg dose) (semaglutide)." Novo Nordisk Pharmaceuticals Inc (2022):

• Gastrointestinal Diseases

  Moderate

  There have been postmarketing reports of acute kidney injury and worsening of chronic renal failure, which may sometimes require hemodialysis, in patients treated with GLP-1 receptor agonists, such as semaglutide. Some events occurred without underlying renal disease, and the majority of events occurred in patients experiencing gastrointestinal reactions (nausea, vomiting, dehydration). It is recommended to monitor renal function when initiating or escalating doses of semaglutide in patients reporting severe adverse gastrointestinal reactions. No dose adjustment is recommended for patients with renal impairment.

  1 source

  1. "Product Information. Ozempic (1 mg dose) (semaglutide)." Novo Nordisk Pharmaceuticals Inc (2022):

• Hypoglycemia

  Moderate

  The concomitant use of semaglutide with insulin and insulin secretagogues (e.g., sulfonylurea) may increase the risk of hypoglycemia. It is recommended to use caution and a lower dose of insulin or insulin secretagogue may be required to minimize the risk of hypoglycemia when these agents are used in combination with semaglutide.

  1 source

  1. "Product Information. Ozempic (1 mg dose) (semaglutide)." Novo Nordisk Pharmaceuticals Inc (2022):

• Pancreatitis

  Moderate

  Pancreatitis has been reported with the use of semaglutide. It is recommended to carefully observe patients for signs and symptoms of pancreatitis (including persistent severe abdominal pain, sometimes radiating to the back and which may or may not be accompanied by vomiting) after therapy initiation. Discontinue treatment if pancreatitis is suspected and manage as appropriate; if confirmed, do not restart treatment with semaglutide and reevaluate for appropriate treatment.

  1 source

  1. "Product Information. Ozempic (1 mg dose) (semaglutide)." Novo Nordisk Pharmaceuticals Inc (2022):

Therapeutic duplication

Drug classes that overlap with Semaglutide, so taking both doubles up the same effect. This source publishes no per-row citations for duplication.

• incretin-based therapies

  The recommended maximum number of medicines in the 'incretin-based therapies' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'incretin-based therapies' category.

  Example product in the source data (US market): Insulin degludec/liraglutide

• incretin-based therapies

  The recommended maximum number of medicines in the 'incretin-based therapies' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'incretin-based therapies' category.

  Example product in the source data (US market): Soliqua