Ozempic (semaglutide) has potential interactions with other drugs and some supplements. For example, Ozempic can interact with oral medications and some diabetes medications, including insulin.
Ozempic (semaglutide) is used for the following purposes:
- to manage blood sugar levels in adults with type 2 diabetes
- to decrease the risk of cardiovascular events (which involve the heart or blood vessels), such as a heart attack or stroke, in adults with both type 2 diabetes and heart disease
- to reduce the risk of kidney disease progression and serious heart-related problems in adults with type 2 diabetes and chronic (long-term) kidney disease
An interaction can occur because one substance causes another substance to have a different effect than expected. Interactions can also occur if you have certain health conditions.
Keep reading to learn about Ozempic’s possible interactions. And for more information about Ozempic, including details about its uses, see this in-depth Ozempic article.
Certain health conditions or other factors could raise your risk of harm if you use Ozempic. In such cases, your doctor may not prescribe Ozempic for you. These are known as contraindications. The following list includes contraindications of Ozempic.
If you have a personal or family history of thyroid cancer: Doctors usually will not prescribe Ozempic to people with a personal or family history of medullary thyroid cancer (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN 2).
This is because Ozempic has a boxed warning for the risk of thyroid tumors and thyroid cancer. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous. For more information, see “Boxed warning: Risk of thyroid cancer” at the beginning of this article.
If you or someone in your family has had MTC or MEN 2, tell your doctor. In this case, they’ll likely recommend a treatment other than Ozempic for your condition.
If you’ve had an allergic reaction: If you’ve had an allergic reaction to Ozempic or any of its ingredients, your doctor likely won’t prescribe Ozempic. This is because using the drug could cause another allergic reaction. You can ask the doctor about other treatments that may be better options for you.
Before you start using Ozempic, talk with your doctor if any of the preceding factors apply to you. Your doctor can determine whether Ozempic is safe for you to use.
There aren’t any known interactions between Ozempic and alcohol.
One of Ozempic’s uses is to help manage blood sugar levels. Alcohol may affect your blood sugar levels, making them harder to manage. As a result, your doctor may recommend not consuming large amounts of alcohol during Ozempic treatment.
If you drink alcohol, and you have questions about consuming it during your treatment with Ozempic, talk with your doctor. They can let you know how much alcohol, if any, may be safe for you to consume while you’re using Ozempic.
Before you start using Ozempic, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether Ozempic interacts with supplements, herbs, and vitamins, see the “Are there other interactions with Ozempic?” section.)
Ozempic’s manufacturer doesn’t list any medications that should not be taken with Ozempic. If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.
The following table lists drugs that may interact with Ozempic. Keep in mind that this table does not include all drugs that may interact with Ozempic. For more information about some of these interactions, see the “Drug interactions explained” section.
| Drug group or drug name | Drug examples | What can happen |
|---|---|---|
| insulin | • insulin lispro (Humalog) • insulin degludec (Tresiba) • insulin glargine (Lantus, Basaglar) | can increase the risk of side effects from Ozempic and insulin |
| sulfonylureas, a kind of diabetes medication | • glimepiride • glyburide (DiaBeta) • glipizide (Glucotrol XL) | can increase the risk of side effects from sulfonylureas and Ozempic |
| antimalarial drugs | • hydroxychloroquine (Plaquenil) • chloroquine | can increase the risk of side effects from Ozempic |
| oral medications | • warfarin (Jantoven) • digoxin (Lanoxin) • sitagliptin (Januvia) • many others | can make oral medications less effective than usual |
| certain antibiotic drugs | • amoxicillin • clarithromycin | can increase the risk of side effects from Ozempic |
What drugs should not be taken with Ozempic?
Ozempic’s manufacturer doesn’t list any specific medications that should not be taken with Ozempic. Some medications could interact with Ozempic by increasing your risk of side effects or becoming less effective when taken with Ozempic. If you take one of these medications, your doctor may monitor you more closely or recommend adjusting your dosage.
Be sure to talk with your doctor or pharmacist before taking any over-the-counter or prescription drugs with Ozempic. They can confirm that other drugs are safe to take while you’re using Ozempic.
Learn more about certain drug interactions that can occur with Ozempic.
Interaction with oral medications
Ozempic may interact with oral medications, which are drugs that you swallow. Currently, there’s not much information on which oral drugs Ozempic may interact with. But some oral drugs can be greatly affected by very small changes in their amount. Examples include:
What could happen
Ozempic can affect how some oral medications are absorbed because it slows the emptying of your stomach. This means that certain medications, such as blood thinners (warfarin), heart medications (digoxin), and diabetes drugs (sitagliptin) may take longer to start working.
This does not necessarily make an oral medication less effective, but it may require close monitoring.
What you can do
Before you start Ozempic treatment, tell your doctor about any oral medications that you take. They may monitor you more often for side effects of your oral drugs and to see how well those drugs are working for you. They may also recommend a dosage change for your oral drug during Ozempic treatment.
Interaction with insulins
If you have type 2 diabetes, your doctor may recommend using Ozempic together with insulin to treat your condition. People with diabetes often use multiple medications to help manage blood sugar levels. But Ozempic may interact with insulin medications.
Examples of insulin medications include:
What could happen
Both insulin and Ozempic can cause a low blood sugar level. Using Ozempic with insulin may increase your risk of this side effect, which can be severe or even life threatening.
What you can do
If you use Ozempic together with insulin, your doctor may recommend monitoring your blood sugar level more often. They may also recommend monitoring yourself for symptoms of low blood sugar, such as shaking, sweating, and dizziness.
If you have diabetes, it’s important for you and your doctor to discuss your plan for treating low blood sugar. Here are some general tips, but be sure to follow the treatment plan you and your doctor agree on.
For mild low blood sugar: Try following the 15-15 rule: Eat 15 grams of carbohydrates, then recheck your blood sugar in 15 minutes. Continue repeating these steps until your blood sugar is back in your target range.
For severe low blood sugar: Blood sugar below 55 milligrams per deciliter is considered severe and should not be treated using the 15-15 rule. Your doctor may prescribe glucagon to you for treating severe low blood sugar. After using glucagon, immediately contact your doctor or seek urgent care.
If you don’t have glucagon available, immediately go to the closest emergency room. In rare cases, severe low blood sugar can be life threatening.
To reduce your risk of a low blood sugar level, your doctor may adjust your dosage of Ozempic or insulin.
Interaction with antimalarial drugs
Ozempic may interact with antimalarial drugs. These are drugs that help treat or prevent malaria, a disease caused by certain parasites. Antimalarials also help treat some autoimmune conditions (in which a person’s immune system attacks their own body), such as rheumatoid arthritis and lupus.
Examples of antimalarial medications include:
- hydroxychloroquine (Plaquenil)
- chloroquine
What could happen
Using Ozempic together with an antimalarial drug can cause low blood sugar. This side effect can be serious or even life threatening.
What you can do
If you need to take any antimalarial medications during your treatment with Ozempic, talk with your doctor. Due to the risk of low blood sugar, they may recommend monitoring your blood sugar level more often during Ozempic treatment.
Your doctor may also recommend monitoring yourself for symptoms of low blood sugar, such as shaking, sweating, and dizziness.
In some cases, they may suggest decreasing your dosage of Ozempic or other diabetes medications you take. This may help lower your risk of low blood sugar.
Ozempic may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests.
Here are additional interactions that may occur with Ozempic. Note that this is not a full list of all other possible interactions with Ozempic.
Does Ozempic interact with supplements?
Before you start using Ozempic, talk with your doctor and pharmacist about any supplements, herbs, and vitamins you take. Sharing this information with them may help you avoid possible interactions.
If you have questions about interactions that may affect you, talk with your doctor or pharmacist.
Ozempic interactions with herbs
Some herbal supplements can cause changes in your blood sugar level. Since Ozempic works to decrease blood sugar, your doctor may recommend avoiding certain herbal supplements, such as:
Before taking any herbal supplements, talk with your doctor or pharmacist. They can determine whether those supplements may interact with Ozempic.
Ozempic and vitamins
There are currently no reports of Ozempic interacting with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future.
For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while using Ozempic.
Does Ozempic interact with food?
There are currently no reports of Ozempic interacting with food. This includes foods or herbs that may interact with Ozempic when taken in supplement form, such as prickly pear, bitter melon, and fenugreek.
If you have questions about eating certain foods during your treatment with Ozempic, talk with your doctor.
Does Ozempic interact with vaccines?
There aren’t any known interactions between Ozempic and vaccines. But if you need to have any vaccines, be sure to tell your doctor or pharmacist which medications you take beforehand. They can let you know whether it’s safe for you to get the vaccine.
Does Ozempic interact with lab tests?
There aren’t any known interactions between Ozempic and lab tests. If you need to have lab tests done, be sure to tell your doctor about medications that you take beforehand. They can let you know if any of your medications may affect test results.
Does Ozempic interact with cannabis or CBD?There are currently no reports of Ozempic interacting with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But as with any drug or supplement, talk with your doctor before using cannabis with Ozempic.
Keep in mind that Ozempic may interact with oral forms of cannabis (forms that you swallow), such as tablets, capsules, and gummies. This is similar to how Ozempic may interact with oral medications. (For more information, see the “Interaction with oral medications” section.)
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Certain medical conditions or other health factors may raise the risk of interactions with Ozempic. As a result, some people should not use Ozempic. Before using Ozempic, talk with your doctor about your health history. They’ll determine whether Ozempic is right for you.
Health conditions or other factors that might interact with Ozempic include:
Delayed emptying of the stomach: Ozempic can cause digestive system side effects, such as nausea or diarrhea, that can become severe. As a result, the manufacturer recommends against prescribing this drug for people with severe gastroparesis (delayed emptying of the stomach). Tell your doctor if you have this condition. They may recommend other treatment options suitable for you.
Upcoming surgeries: If you have any upcoming procedures or surgeries, make sure your doctor knows that you’re receiving Ozempic. Ozempic may increase the risk of pulmonary aspiration (accidental inhalation of something into your airway, typically food from your stomach) during sedation or general anesthesia. Ozempic slows down the rate at which your stomach empties and this may raise the risk of aspiration during sedation or anesthesia. More research about this risk is needed.
A personal or family history of thyroid cancer: Doctors usually will not prescribe Ozempic to people with a personal or family history of medullary thyroid cancer (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN 2).
This is because Ozempic has a boxed warning for risk of thyroid tumors and thyroid cancer. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For more information, see “Boxed warning” at the beginning of this article.
If you or someone in your family has had MTC or MEN 2, tell your doctor. In this case, they’ll likely recommend a treatment other than Ozempic for your condition.
Side effects that cause dehydration and kidney problems: Ozempic can cause side effects such as vomiting and diarrhea, which may lead to dehydration. If your body loses too much fluid, this can cause sudden kidney injury, especially if you already have kidney problems or other risk factors.
If you experience ongoing nausea, vomiting, or diarrhea, contact your doctor. They may monitor your kidney function with blood tests to make sure your kidneys are working properly. If you have a kidney problem, let your doctor know before starting Ozempic to determine whether it’s a safe option for you.
Pancreas issues: Although rare, it’s possible for Ozempic to cause pancreatitis (inflammation of the pancreas). In people with pancreas issues, Ozempic may worsen their condition. If you have any pancreas issues, tell your doctor before using Ozempic. This can help them determine whether Ozempic is a safe treatment for you.
Diabetic retinopathy: Ozempic may cause worsening symptoms of diabetic retinopathy, an eye condition related to diabetes. If you have diabetic retinopathy, tell your doctor before you start receiving Ozempic. They may recommend more frequent monitoring for this side effect during treatment.
Pregnancy: At this time, it’s not known whether Ozempic is safe to use during pregnancy. If you’re pregnant or planning to become pregnant, ask your doctor about the risks and benefits of using this drug.
Breastfeeding: At this time, it’s not known whether Ozempic is safe to use while breastfeeding. If you’re breastfeeding or planning to breastfeed, ask your doctor about the risks and benefits of using this drug.
Allergic reaction: If you’ve had an allergic reaction to Ozempic or any of its ingredients, your doctor will likely not prescribe Ozempic. This is because using the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.
Find answers to some frequently asked questions about Ozempic and possible interactions.
Does Ozempic interact with Benadryl?
No, there aren’t any known interactions between Ozempic and diphenhydramine (Benadryl). It’s likely safe for you to take Benadryl during your treatment with Ozempic.
Note that it’s possible for Ozempic to decrease the speed at which your stomach empties its contents. This may affect how well oral medications such as Benadryl are absorbed into your body.
If you have questions about the safety of using Ozempic with Benadryl, talk with your doctor or pharmacist.
Are there any interactions between Ozempic and Tylenol?
No, there aren’t any known interactions between Ozempic and acetaminophen (Tylenol). So it’s likely safe to use them together.
Note that it’s possible for Ozempic to decrease the speed at which your stomach empties its contents. This may affect how well oral medications such as Tylenol are absorbed into your body.
If you have any questions about using Ozempic with Tylenol, talk with your doctor or pharmacist.
Taking certain steps can help you avoid interactions with Ozempic. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:
- whether you drink alcohol or use cannabis
- the
list of medications you take, as well as any vitamins, supplements, and herbs - what to do if you start taking a new drug during your Ozempic treatment
It’s also important to read Ozempic’s
You may see colored stickers on the label that describe interactions. And the paperwork (sometimes called the patient package insert or medication guide) may have other details about interactions. (If you did not get paperwork with Ozempic, ask your pharmacist to print a copy for you.) If you have difficulty understanding this information, your doctor or pharmacist can help.
Using Ozempic exactly as prescribed can also help prevent interactions.
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.