6 drugs you should not take with Ozempic

If you are on Ozempic (semaglutide) or considering it, you might wonder if there are drugs you should avoid while on it. While there aren’t any official drug interactions with Ozempic, there are some medications to be aware of while taking Ozempic. 

So, what drugs should not be taken with Ozempic? Here are the possible Ozempic drug interactions to be aware of:

• Insulin: Taken for diabetes; may cause hypoglycemia if taken with Ozempic

• Sulfonylureas: Taken for diabetes; may cause hypoglycemia if taken with Ozempic

• Glinides: Taken for diabetes; may cause hypoglycemia if taken with Ozempic

• Oral medications and supplements: Ozempic can make some oral medications less effective

• Alcohol: There’s no evidence Ozempic interacts with alcohol, but alcohol can lower blood sugar, and taking both together could increase the risk for hypoglycemia

• Certain foods: Greasy or fried foods may worsen Ozempic’s gastrointestinal (GI) side effects

Let’s review the most common Ozempic interactions you should know about before taking Ozempic.

What insulin is used for: It helps people with type 2 diabetes control their blood sugar.

How insulin interacts with Ozempic: Ozempic can increase the risk of low blood sugar (hypoglycemia) when taken with insulin.

Why this interaction matters: Hypoglycemia can cause shaking, sweating, dizziness, and confusion, among other symptoms. 

What you should do: If you take insulin and Ozempic, your healthcare provider will adjust your doses so your blood sugar reaches healthy levels. Monitor your blood sugar levels during treatment and let your provider know if you get low readings.   

If you have type 2 diabetes, your body can’t release or use insulin as well as it naturally should, which can result in high blood sugar levels. Many people with type 2 diabetes take insulin because it helps convert sugar (glucose) into energy that can be used by the body. It also lowers blood sugar to prevent harmful effects of high blood sugar. Ozempic is another drug taken to regulate blood sugar levels by mimicking the hormone glucagon-like peptide-1 (GLP-1), which tells the pancreas to release insulin, among other effects.  

While Ozempic doesn’t usually cause hypoglycemia, insulin can, and taking Ozempic and insulin together to lower blood sugar can increase the risk of hypoglycemia. Hypoglycemia can cause symptoms like shaking, sweating, dizziness, and confusion. 

Your healthcare provider may adjust your dosage of insulin or Ozempic to prevent this side effect. Keep an eye on your blood sugar levels during treatment and let your provider know if your levels drop too low.

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What sulfonylureas are used for: This oral diabetes drug class helps control blood sugar.

How sulfonylureas interact with Ozempic: When combined, they can cause hypoglycemia.

Why this interaction matters: Hypoglycemia can cause shaking, sweating, dizziness, and confusion, among other symptoms. 

What you should do: Talk with your healthcare provider about potentially adjusting your dose if you have low blood sugar. Monitor your blood sugar levels during treatment and let your provider know if you get high or low readings. 

Sulfonylureas are oral diabetes medications that help control blood sugar levels. Examples of sulfonylureas include glipizide, glimepiride, and glyburide. Sulfonylureas work by telling the pancreas to release more insulin.  

Ozempic helps the pancreas release insulin only when you eat and your blood sugar rises. But sulfonylureas trigger insulin release all the time, regardless of blood sugar levels. 

So taking the two together can increase the risk of hypoglycemia. To lower the potential risk of dangerously low blood sugar, your healthcare provider may adjust your dosage of Ozempic or sulfonylurea.

What glinides are used for: These oral diabetes medications lower blood sugar levels.

How glinides interact with Ozempic: When combined, they can cause hypoglycemia.

Why this interaction matters: Hypoglycemia can cause shaking, sweating, dizziness, and confusion, among other symptoms. 

What you should do: Talk with your healthcare provider about potentially adjusting your dose if you have low blood sugar. Monitor your blood sugar levels during treatment and let your provider know if you get high or low readings. 

Glinides are oral medications similar to sulfonylureas that treat type 2 diabetes. Examples of glinides include repaglinide and nateglinide. They tell the pancreas to release insulin, which then helps lower your blood sugar. Taking glinides and Ozempic at the same time may increase the risk of hypoglycemia. To lower this risk, your healthcare provider may adjust your dosage of glinide or Ozempic. 

If you take a glinide, tell your healthcare provider before starting Ozempic. Ask for their advice on recognizing the signs of low blood sugar and managing your blood sugar levels.

How oral medications and supplements interact with Ozempic: Ozempic can potentially lessen the effectiveness of certain oral medications because of how the drug works in the stomach, but there’s currently no specific known interactions between Ozempic and oral medications and supplements.

Why this interaction matters: It can be dangerous if certain medications, like warfarin or digoxin, become less effective in the body. 

What you should do: Talk with your healthcare provider about all the medications you take, including prescription or over-the-counter (OTC) medications, supplements, herbs, or vitamins. They may recommend dose adjustments, if needed.  

Ozempic slows down the rate at which food leaves your stomach. While this helps prevent blood sugar spikes, it can also slow the absorption process of oral medications with a narrow therapeutic index, like warfarin and digoxin, because they stay in your stomach longer. This could potentially put your health at risk, since the oral medication is no longer working as well as it should. 

With that said, this is a theoretical risk, as there’s no clear evidence that this delay can actually cause problems. There also aren't any known interactions between supplements and Ozempic. And there isn’t a lot of research on how supplements affect diabetes medications. 

Still, it’s important to tell your healthcare provider about all the medications you take before starting Ozempic, especially oral prescription or OTC drugs, supplements, herbs, or vitamins.  They may have recommendations for how to adjust your dosage to avoid any adverse effects.

How alcohol interacts with Ozempic: There’s no evidence that alcohol interacts with Ozempic, but alcohol and Ozempic can both lower blood sugar.

Why this interaction matters: Drinking while taking Ozempic may put you at risk for hypoglycemia, especially if you take insulin or another drug that lowers blood sugar.

What you should do: Consider limiting your alcohol use and talking with your healthcare provider if you notice high or low blood sugar levels.  

Alcohol and Ozempic can both lower blood sugar, so taking them together could increase the risk of hypoglycemia — particularly for people with type 2 diabetes who take insulin or any other drug that lowers blood sugar.

Currently, the Ozempic prescribing information doesn’t list any interactions between alcohol and Ozempic. But because they can both lower blood sugar, you may want to limit or avoid drinking alcohol while taking Ozempic to be on the safe side and prevent any interactions.

It’s recommended to limit alcohol to one drink or less per day for women, and two drinks or less per day for men.

How certain foods interact with Ozempic: There are no known interactions, but some fried or greasy foods can worsen Ozempic’s side effects.

Why this interaction matters: Eating fried or greasy food can worsen Ozempic’s often unpleasant GI side effects like nausea, bloating, or gas.

What you should do: Avoid or limit fried or greasy foods if you notice it worsens your GI side effects.

Currently, no foods are known to interact with Ozempic. However, fried or greasy foods may worsen some of the side effects of Ozempic or create overlapping symptoms like nausea, heartburn, bloating, or gas. 

If you have nausea while taking Ozempic, try the following:

• Eat bland, low-fat foods like crackers and rice

• Eat foods that have a lot of water, like soup

• Eat more slowly

• Drink ice-cold water

• Avoid lying down after eating

• Go outside for fresh air

Before starting Ozempic, fill your healthcare provider in on your personal and family medical history, including any medical conditions and drugs or supplements you take.

According to Ozempic’s prescribing information, certain people shouldn’t take Ozempic or should be evaluated by a healthcare provider before using the drug. 

You should not take Ozempic if:

• You have multiple endocrine neoplasia syndrome type 2

• You have a personal or family history of medullary thyroid carcinoma

• You have an allergy to Ozempic or its ingredients

• You’re pregnant or breastfeeding (it’s advised to stop taking Ozempic at least two months before pregnancy)

Complications while on Ozempic may include:

• Pancreatitis

• Diabetic retinopathy

• Kidney problems

• Gallbladder problems

Before starting Ozempic, tell your healthcare provider if you or anyone in your family has any of the above conditions. This will help them determine if Ozempic is safe for you to use or if another medication would be a better option.

It’s important to be aware that while there are no official drug interactions with Ozempic, that could change in the future with more research. Talk with your healthcare provider about all the medications you take, and if you have questions about potential drug interactions. 

The following table shows the different medication classes and specific examples that may interact with Ozempic. These medications aren’t necessarily off-limits completely while you take Ozempic. Your healthcare provider will help you decide what’s best for you. 

To avoid interactions with Ozempic, talk with your healthcare provider beforehand. Tell them about:

• Medical conditions you have

• Medical conditions that run in your family 

• Prescription and OTC drugs you take

• Vitamins, supplements, or herbs you use 

Always take your medication as prescribed and follow the dose recommended by your healthcare provider. Ask them if any instructions they give are unclear, or if you have any questions, including possible drug interactions.  

Read through the paperwork you receive with your prescription. Ozempic will come with information on:

• How to inject Ozempic

• Storage instructions (keep Ozempic in your refrigerator)

• Any potential drug interactions

If you take insulin or insulin secretagogues like sulfonylureas or glinides, you may be at higher risk for low blood sugar when taking Ozempic. Ozempic may also slow the absorption of other orally administered medications. Your healthcare provider may adjust your dosage to avoid any of these possible interactions. 

Finally, no foods have been known to cause interactions with Ozempic. But you may want to limit alcohol and greasy, fried, or sugary foods to avoid increasing nausea or other GI symptoms. 

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You might be wondering if there are drug interactions with Ozempic or medications you should avoid. While there aren’t any specific reported drug interactions, it’s always a good idea to inform your healthcare provider about the medications you take so they can be aware and make dose adjustments if needed. 

Here are the most important things to understand about medication interactions while taking Ozempic. 

• There are no documented drugs to avoid while taking Ozempic, but some diabetes drugs can increase the risk of low blood sugar while taking Ozempic, including insulin, sulfonylureas, and glinides.

• Ozempic might make some oral medications you take less effective. 

• Some health conditions, like certain cancers, medication allergies, and pregnancy, make Ozempic unsafe to take (or only safe under the close supervision of a healthcare provider). 

• Tell your healthcare provider about all the medications you take, including prescription and OTC drugs and supplements. 

• This article reviews the main Ozempic interactions known at this time, and it may not be an exhaustive list.