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Health Guide / GLP-1

Ozempic and alcohol: is it safe to mix the two?

felix gussoneAmelia willson

Reviewed by Felix Gussone, MD, written by Amelia Willson

Last updated: Apr 07, 2023
6 min read

table of contents

  1. What is Ozempic?
  2. What conditions does Ozempic treat?
  3. Can you drink alcohol and take Ozempic?
  4. What should you avoid when taking Ozempic?

When taking any prescription medication, it’s a good idea to look into whether it’s safe to consume alcohol. If you’ve been prescribed Ozempic (see Important Safety Information) to manage your type 2 diabetes or help with weight loss, you may want to know if you can have a cocktail or a glass of wine (or two) while taking the medication. While Ozempic is not known to dangerously interact with alcohol, for those with type 2 diabetes, drinking alcohol while taking Ozempic may lower your blood sugar and cause serious hypoglycemia (a blood sugar level lower than the standard range).

Continue reading to learn more about mixing Ozempic and alcohol.

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What is Ozempic?

Ozempic is a type of drug called a glucagon-like peptide-1 receptor agonist (GLP-1) prescribed to help people with type 2 diabetes control their blood sugar levels. It’s a prescription injectable medication that you self-inject weekly, with or without meals. Ozempic may also be prescribed-off label by a healthcare provider to support weight loss, even in those without type 2 diabetes. 

Can you drink alcohol while taking Ozempic?

Ozempic is not known to dangerously interact with alcohol. However, that doesn’t mean the combination is safe for everyone. Whether you take Ozempic for type 2 diabetes, weight loss, or both, there may still be reasons to avoid alcohol. Here’s how drinking alcohol while taking Ozempic affects those taking the medication for managing type 2 diabetes and for weight loss:

Type 2 diabetes, alcohol, and Ozempic

If you have type 2 diabetes and take Ozempic to control your blood sugar levels, you may want to exercise more caution when it comes to alcohol. Alcohol can negatively affect your blood glucose levels while taking Ozempic, causing them to drop too low (hypoglycemia).

If your diabetes is well controlled, it’s generally considered okay to drink moderately. That means fewer than two drinks per day for men, and fewer than one drink per day for women. On the other hand, if your diabetes is not well controlled, or if you have other medical conditions—such as high blood pressure, liver problems, or high triglycerides—it may be safest to avoid alcohol entirely. You should also avoid alcohol if you are pregnant or breastfeeding. Talking to your healthcare provider about your personal risk level is always a good idea.

Regardless of whether or not your diabetes is well controlled, people with type 2 diabetes should avoid drinking alcohol on an empty stomach. Drinking on an empty stomach increases the risk of hypoglycemia. Monitor your blood sugar levels when consuming alcohol and watch for symptoms of low blood sugar. 

Weight loss, alcohol, and Ozempic

If you are taking Ozempic solely for weight loss, you may still want to limit your alcohol consumption. Excessive alcohol use has been linked with overeating and may be a risk factor for obesity and weight gain — something you’re actively trying to prevent while taking Ozempic.

In particular, people who are more impulsive may be more likely to overeat during or after drinking alcohol. Chronic heavy drinking may increase your risk of type 2 diabetes mellitus and pancreatitis.

When drinking moderately, avoid sugary drinks and cocktails containing soda and juice. Instead, opt for distilled spirits, wine, and low-calorie cocktails. No matter who you are, drinking alcohol is never without risk. Alcohol consumption may increase your risk of liver disease, heart disease, strokes, cancer, and more. And, despite some studies suggesting that moderate drinking comes with certain health benefits, a new analysis has concluded that many of those studies were poorly designed, and that the opposite is true: no amount of drinking seems to be good for you.

How much alcohol is too much when taking Ozempic?

While sugary drinks may stand in the way of your weight loss goals, moderate alcohol consumption is typically not associated with obesity (heavy drinking is). Moderate alcohol consumption means you drink fewer than two drinks per day if you’re a guy, and one drink or less if you’re a woman. For perspective:

  • 1 drink = 12 oz beer = 1.5 oz liquor = 4 oz wine

If your main concern is keeping your blood sugar levels in control, limit sugary beverages containing soda and juice as previously mentioned, and stick to low sugar options.

How long should you wait to drink alcohol after taking Ozempic?

Because alcohol consumption in and of itself does not dangerously interact with Ozempic, feel free to moderately and safely consume alcohol with Ozempic during any time frame. However, if drinking alcohol is likely to make you forget to take your medication, consider taking Ozempic before your night out on the town or set an alarm to remind yourself to take your medication.

What conditions does Ozempic treat?

Ozempic is primarily used to treat type 2 diabetes. When used in combination with lifestyle changes like diet and exercise, or with other diabetes medications such as metformin, Ozempic helps people with type 2 diabetes control their blood sugar levels. Ozempic also lowers the risk of stroke, heart attack, or death in people with type 2 diabetes and heart disease.

Ozempic may also be prescribed off-label to adults with obesity to help them with weight loss because it may reduce your appetite. When combined with diet and exercise, this effect can help people with excess weight or obesity to lose weight faster.

Ozempic drug interactions

Ozempic is safe to use with most medications, but there are a couple of things to be aware of. If you are taking Ozempic with other diabetes medications, like insulin, you are at higher risk of developing low blood sugar and your medication doses may need adjustments.

GLP-1 receptor agonists like Ozempic can also affect how quickly your body absorbs oral medications, because it slows down how the medications move through your stomach into your intestines. To be safe, talk to your healthcare provider about other medications you are taking, and follow their medical advice.

Ozempic warnings

Your healthcare provider may advise you to avoid smoking if you have type 2 diabetes. Smoking cigarettes can cause high blood sugar levels and worsen insulin resistance, which can interfere with your glycemic control. If you are in the process of quitting smoking, it can take some time for your body and blood sugar levels to adjust to the change. Because Ozempic can lower blood sugar levels, ask your healthcare provider about what they recommend for you.

The Food and Drug Administration (FDA) has issued a “black box” warning for Ozempic. This is the most serious advisory issued for a medication. While we don’t know if Ozempic has the same effect in humans, animal studies have found that Ozempic increases the risk of thyroid tumors in mice. People with a personal or family history of thyroid cancer, or who have multiple endocrine neoplasia syndrome type 2, should not use Ozempic.

Remember that consuming alcohol is never without risk. While it may be safe to drink moderately while taking Ozempic, have a conversation with your healthcare provider to be sure that consuming alcohol won’t have a negative impact on your treatment plan.

Disclaimer

If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.

References

  1. Asif, M. (2014). The prevention and control the type-2 diabetes by changing lifestyle and dietary pattern. Journal of Education and Health Promotion, 3, 1. doi:10.4103/2277-9531.127541. Retrieved from https://pubmed.ncbi.nlm.nih.gov/24741641/
  2. Campagna, D., Alamo, A., Di Pino, A., et al. (2019). Smoking and diabetes: dangerous liaisons and confusing relationships. Diabetology & Metabolic Syndrome, 11, 85. doi:10.1186/s13098-019-0482-2. Retrieved from https://pubmed.ncbi.nlm.nih.gov/31666811/
  3. Canadian Agency for Drugs and Technologies in Health (CADTH). (2019). Clinical review report: semaglutide (Ozempic): (Novo Nordisk Canada Inc.). Canadian Agency for Drugs and Technologies in Health. Retrieved from https://pubmed.ncbi.nlm.nih.gov/31305971/ 
  4. Chamberlin, S. & Dabbs, W. (2019). Semaglutide (Ozempic) for type 2 diabetes mellitus. American Family Physician, 100(2), 116–117. Retrieved from https://pubmed.ncbi.nlm.nih.gov/31305048/
  5. DailyMed. (2022). OZEMPIC-semaglutide injection, solution. National Library of Medicine. Retrieved from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=adec4fd2-6858-4c99-91d4-531f5f2a2d79 
  6. Food and Drug Administration (FDA). (2020). Drug trial snapshot: Ozempic. Food and Drug Administration. Retrieved from https://www.fda.gov/drugs/drug-approvals-and-databases/drug-trial-snapshot-ozempic
  7. Kase, C. A., Piers, A. D., Schaumberg, K., et al. (2016). The relationship of alcohol use to weight loss in the context of behavioral weight loss treatment. Appetite, 99, 105–111. doi:10.1016/j.appet.2016.01.014. Retrieved from https://pubmed.ncbi.nlm.nih.gov/26792773/
  8. Kim, S. J. & Kim, D. J. (2012). Alcoholism and diabetes mellitus. Diabetes & Metabolism Journal, 36(2), 108–115. doi:10.4093/dmj.2012.36.2.108. Retrieved from https://pubmed.ncbi.nlm.nih.gov/22540046/ 
  9. Knott, C., Bell, S., & Britton, A. (2015). Alcohol consumption and the risk of type 2 diabetes: A systematic review and dose-response meta-analysis of more than 1.9 million individuals from 38 observational studies. Diabetes Care, 38(9), 1804–1812. doi:10.2337/dc15-0710. Retrieved from https://pubmed.ncbi.nlm.nih.gov/26294775/
  10. Maideen, N. M. P. (2019). Pharmacologically relevant drug interactions of glucagon-like peptide-1 receptor agonists. Journal of Analytical & Pharmaceutical Research, 8(2), 51‒53. doi:10.15406/japlr.2019.08.00311. Retrieved from https://www.researchgate.net/publication/333746529_Pharmacologically_relevant_drug_interactions_of_Glucagon-like_peptide-1_receptor_agonists 
  11. NIH. (n.d.). Drinking Levels Defined. Retrieved Mar. 29, 2023 from https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking
  12. O’Neil, P. M., Birkenfeld, A. L., McGowan, B., et al. (2018). Efficacy and safety of semaglutide compared with liraglutide and placebo for weight loss in patients with obesity: a randomised, double-blind, placebo and active controlled, dose-ranging, phase 2 trial. Lancet (London, England), 392(10148), 637–649. doi:10.1016/S0140-6736(18)31773-2. Retrieved from https://pubmed.ncbi.nlm.nih.gov/30122305/
  13. Traversy, G. & Chaput, J. P. (2015). Alcohol consumption and obesity: An update. Current Obesity Reports, 4(1), 122–130. doi:10.1007/s13679-014-0129-4. Retrieved from https://pubmed.ncbi.nlm.nih.gov/25741455/ 
  14. Wilding, J., Batterham, R. L., Calanna, S., et al. (2021). Once-weekly semaglutide in adults with overweight or obesity. The New England Journal of Medicine, 384(11), 989–1002. doi:10.1056/NEJMoa2032183. Retrieved from https://pubmed.ncbi.nlm.nih.gov/33567185/
  15. Zhao, J., Stockwell, T., Naimi, T., et al. (2023). Association Between Daily Alcohol Intake and Risk of All-Cause Mortality: A Systematic Review and Meta-analyses. JAMA Netw Open, 6(3), e236185. doi: 10.1001/jamanetworkopen.2023.6185 Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10066463/
felix gussone
Felix Gussone, MD

Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.

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Important Safety Information for Ozempic®

Important Safety Information for Ozempic (semaglutide) injection

Warning: Risk of Thyroid C-Cell Tumors

  • In studies with mice and rats, semaglutide (the active ingredient in Ozempic and Wegovy) caused thyroid tumors, including thyroid cancer. It is not known if Ozempic will cause thyroid tumors or a type of thyroid cancer called medullary thyroid carcinoma (MTC) in people. Tell your provider if you get a lump or swelling in your neck, hoarseness, trouble swallowing, or shortness of breath. These may be symptoms of thyroid cancer. 
  • Do not use Ozempic if you or any of your family have ever had a type of thyroid cancer called medullary thyroid carcinoma (MTC) or if you have an endocrine system condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).

What is the FDA-approved use of Ozempic?

Ozempic is a glucagon-like peptide-1 (GLP-1) receptor agonist that is used:

  • with diet and exercise to improve glycemic control in patients with type 2 diabetes mellitus.
  • to reduce the risk of major adverse cardiovascular events in patients with type 2 diabetes mellitus and established cardiovascular disease.

Limitations of Use:

  • Ozempic has not been studied in patients with a history of pancreatitis.
  • Ozempic is not for treatment of type 1 diabetes mellitus.

Your Ro-affiliated provider may recommend the use of Ozempic as treatment for chronic weight management (obesity or overweight).

Who should not use Ozempic?

Do not use Ozempic if:

  • You or any of your family have ever had a type of thyroid cancer called medullary thyroid carcinoma (MTC) or if you have an endocrine system condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
  • You have a known allergic reaction to semaglutide (the active ingredient in Wegovy or Ozempic). 

How should Ozempic be administered? 

You can take Ozempic with or without food. The pre-filled injector pen is self-administered as a subcutaneous injection in the stomach, thigh, or upper arm once a week on the same day every week. Your Ro-affiliated provider will guide you on a treatment regimen that may include an increase in dose every four weeks. 

You should not change your dosing regimen or stop taking Ozempic as prescribed without discussing with your provider first.  

What should I tell my Ro-affiliated provider before using Ozempic?

  • Ozempic has certain drug interactions. It’s important to tell your Ro-affiliated provider all of the medications you are currently taking, including prescription, over-the-counter medications, vitamins, and herbal and dietary supplements. 

Some medications to watch out for include:

  • Medications used to treat type 1 or type 2 diabetes, including insulin or sulfonylureas (such as Amaryl or Glucotrol XL)
  • Ozempic causes a delay in gastric emptying so it has the potential to impact the absorption of medications that are taken by mouth at the same time. Your provider can guide you on how to schedule your medications.
  • Other GLP-1 medications, including Wegovy, Saxenda, Victoza, Byetta, or Bydureon
  • If you’re using other products for weight loss, including dietary supplements

It’s important to share your entire medical history with your provider. In particular, tell your provider if you have a past history of:

  • Type 1 or type 2 diabetes
  • Thyroid cancer
  • Pancreatitis
  • Kidney disease
  • Diabetic retinopathy
  • Depression
  • Suicidal thoughts or behavior

Tell your provider if you are pregnant, planning to become pregnant, or breastfeeding. 

  • If you are pregnant: Ozempic should not be used during pregnancy. Based on animal studies, there may be potential risks to an unborn baby from exposure to Ozempic during pregnancy. There is no benefit to weight loss during pregnancy and it may cause harm to the unborn baby. 
  • If you are a female or male of reproductive potential: Discontinue Ozempic at least 2 months before a planned pregnancy since the drug can stay in the bloodstream for a long time.
  • If you are breastfeeding: Ozempic was found in the milk of lactating rats. Tell your Ro-affiliated provider if you are breastfeeding before you start Ozempic.

Pregnancy registry: There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to semaglutide (the active ingredient in Ozempic and Ozempic) during pregnancy. Pregnant women exposed to semaglutide and healthcare providers are encouraged to contact Novo Nordisk at 1-800-727-6500.

Withholding or providing inaccurate information about your health and medical history in order to obtain treatment may result in harm, including, in some cases, death.

What are the most serious side effects that I or a caregiver should monitor for when taking Ozempic? 

If you are experiencing a medical emergency, call 911 or seek immediate medical attention.

These serious side effects can occur with Ozempic. You or a caregiver should carefully monitor for these side effects, especially in the beginning of treatment and with dose changes.

  • Thyroid C-Cell Tumors: In mice and rats, semaglutide (the active ingredient in Ozempic and Ozempic) caused an increase in thyroid C-cell tumors, including medullary thyroid carcinoma (MTC). It is unknown whether Ozempic causes thyroid C-cell tumors in humans. There were cases of MTC reported in patients who took liraglutide (the active ingredient in Victoza and Saxenda) after the drug was put on the market. Ozempic is contraindicated in patients with a family history of MTC or in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Tell your provider if you get a lump or swelling in your neck, hoarseness, trouble swallowing, or shortness of breath. These may be symptoms of thyroid cancer. 
  • Inflammation of Pancreas (Acute Pancreatitis): Monitor for signs of acute pancreatitis, including severe abdominal pain that does not go away, sometimes radiating to the back, with or without vomiting.
  • Diabetic Retinopathy Complications in Patients with Type 2 Diabetes: If you have type 2 diabetes, tell your provider right away if you experience changes in vision.
  • Never Share a Pen: Pen-sharing poses a risk of infection. 
  • Low Blood Sugar (hypoglycemia): Ozempic lowers blood glucose. It can cause too low blood sugar in patients with type 2 diabetes who also take another glucose control medication. Monitor your blood sugar and watch out for signs of too low blood sugar such as dizziness, blurred vision, mood changes, sweating, or fast heartbeat.
  • Acute Kidney Injury: In people who have kidney problems, diarrhea, nausea, and vomiting may cause a loss of fluids (dehydration) which may cause kidney problems to get worse. It is important for you to drink plenty of water to help reduce your chance of dehydration.
  • Serious Allergic Reactions: Stop using Ozempic right away if you experience symptoms of a serious allergic reaction, including swelling of your face, lips, tongue or throat, severe rash or itching, very rapid heartbeat, problems breathing or swallowing, or fainting or feeling dizzy.
  • Acute Gallbladder Disease: Ozempic may cause gallbladder problems, including gallstones. Some gallbladder problems require surgery. Tell your provider right away if you have pain in your upper stomach, yellowing of skin or eyes (jaundice), fever, or clay-colored stools.
  • Increase in Heart Rate: Tell your provider right away if you have a racing heartbeat while at rest. 
  • Suicidal Behavior and Ideation: You should pay attention to any mental health changes, especially sudden changes in your mood, behaviors, thoughts, or feelings. Call your healthcare provider right away if you have any mental changes that are new, worse, or worry you.

What are the most common side effects of Ozempic?

  • Nausea
  • Vomiting
  • Diarrhea
  • Stomach pain
  • Constipation

You are encouraged to report negative side effects of prescription products:

This information is not comprehensive. Please see the full Prescribing Information for complete safety information.