Can You Take Ozempic With Other Medications?

Ozempic and other drugs like Wegovy and Mounjaro are being touted as safe and effective medications to treat type 2 diabetes and aid in weight loss in patients who are overweight or obese. While these drugs are increasing in popularity, it’s important for patients to understand how they might interact with other medications, including other diabetes treatments and oral prescriptions. 

Ozempic (semaglutide) belongs to a class of drugs called glucagon-like peptide 1 (GLP-1) receptor agonists, Sean Wharton, MD PharmD, an assistant clinical professor of medicine at McMaster University in Hamilton, Ontario, told Verywell.

These drugs control blood sugar levels and help the pancreas release the optimal amount of insulin. They also suppress appetite by slowing down the digestive system, leaving patients fuller for longer.

Because GLP-1 receptor agonists affect insulin production, Ozempic’s safety information label says patients should tell their healthcare provider about any other drugs they may be taking to treat diabetes, like insulin or sulfonylureas. They should also disclose any other prescriptions, over-the-counter medicines, vitamins, or herbal supplements.

Taking Ozempic Alongside Other Diabetes Medication

While insulin is standard for anyone with type 1 diabetes, a person with type 2 diabetes may take insulin to help manage their disease when lifestyle behaviors and oral medications aren’t sufficiently keeping blood sugar levels stable.

People taking Ozempic can also take insulin to manage type 2 diabetes. But drugmaker Novo Nordisk warns that the risk of hypoglycemia—low blood sugar—is increased if a patient is using the medication in combination with insulin or a sulfonylurea, another diabetes medication.

Taking Ozempic with either insulin or a sulfonylurea might be problematic because you’re essentially using two medications that work to lower blood sugar, Andrea Swanson, PharmD, an assistant professor in the Leslie Dan faculty of pharmacy at the University of Toronto, told Verywell. Ozempic by itself, however, won’t cause low blood sugar.

“Ozempic only stimulates insulin release after you eat…so [you’re] in a state of high glucose, and you’re just lowering it,” Swanson said. “But if you’re taking prescription insulin in addition, that can be problematic because you’re stimulating the body’s natural insulin when you eat, plus taking additional insulin.”

Sulfonylureas work by encouraging the pancreas to release insulin to help lower blood sugar levels, so it can pose the same problem as insulin for Ozempic users. 

Swanson said patients who were on high doses of insulin before taking Ozempic, or patients who are already experiencing hypoglycemia to begin with, might be directed to reduce the amount of insulin they’re taking if they’re about to take a GLP-1 receptor agonist.

According to Wharton, reducing the amount of injectable insulin due to Ozempic use can be a good thing. Research shows that using a GLP-1 receptor agonist like Ozempic in combination with insulin can actually help people with type 2 diabetes. This may be due to the fact that taking a drug like Ozempic can improve glucose levels over time, lessening a patient’s reliance on injectable insulin.

“Who wants to be on insulin if you have type 2 diabetes? Nobody,” he said. “The less [insulin] that you can take, the better.”

Research published in the journal Diabetes Spectrum found that patients who use the combination of a GLP-1 receptor agonists and insulin have improved glycemic control and low risks of hypoglycemia and weight gain. The authors said that this combination provides a safe and effective alternative to basal-bolus insulin—which is a regime that involves taking both long-lasting and short-lasting insulin.

Taking Ozempic Alongside Oral Medications

Ozempic slows down stomach emptying, meaning food sits in the body longer. Swanson said the makers of Ozempic studied whether there was a clinically relevant change in the absorption of other medications in patients using Ozempic as a result of this slow down. Some of the drugs studied include birth control pills, heart medications, blood thinners and cholesterol medications, she says.

“They didn’t see any issue in the drugs that they targeted,” she said.

Interactions may not be a major issue. But because fairly common side effects of Ozempic include nausea and vomiting, there’s a possibility patients won’t be able to keep other medications down, Tom Elliott, MBBS, FRCPC, medical director of BCDiabetes, told Verywell. This may necessitate a lower dosage of Ozempic.

People taking thyroid medications should take special care when starting Ozempic.

“Thyroid medication is a drug that is really dependent on how much gets absorbed—it’s very dependent on its movement through the GI tract,” Swanson said. “[Researchers] recommend extra monitoring with that medication.”

Since you can check your own thyroid levels, patients on Ozempic can monitor themselves between check-ins with a provider.

It’s important for patients new to Ozempic to work with their healthcare provider and share any symptoms, issues, or concerns about something like thyroid levels, Swanson said. Drugs like Ozempic are supposed to be monitored over time—not prescribed without any followup.

But overall, taking Ozempic with other medications is relatively safe based on what we know so far.

“There’s not an urgent drug interaction to watch out for,” Swanson said. “But with any medication, there always comes caution and there are always side effects to consider.”