Ozempic interactions: Alcohol, medications, and other factors

In some cases, a factor or condition could prevent your doctor from prescribing Ozempic due to the risk of harm. This is known as a contraindication. The contraindications of Ozempic include:

Having a personal or family history of medullary thyroid carcinoma

Doctors typically won’t prescribe Ozempic if you or a close family member has or has had medullary thyroid carcinoma (MTC). This is a type of thyroid cancer. In fact, Ozempic has a boxed warning about the risk of thyroid cancer. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For more information, see the boxed warning at the beginning of this article.

Having a personal history of multiple endocrine neoplasia syndrome type 2

Doctors usually won’t prescribe Ozempic if you have or have had multiple endocrine neoplasia syndrome type 2 (MEN2). This is a rare endocrine condition that can increase the risk of developing thyroid cancer. Ozempic has a boxed warning about the risk of thyroid cancer. A boxed warning is the most serious warning from the FDA. To learn more, see the boxed warning at the top of this article.

Having had an allergic reaction to Ozempic or any of its ingredients

If you have had an allergic reaction to Ozempic or any of its ingredients, your doctor will likely not prescribe Ozempic. Using the medication could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.

Note: Before you start treatment with Ozempic, it’s important to tell your doctor if any of these contraindications apply to you. They can determine whether to prescribe Ozempic.

You may be wondering if you can drink during Ozempic treatment. There’s no direct interaction between using Ozempic and consuming alcohol.

However, alcohol can lower or raise your blood sugar level. This means alcohol could make Ozempic not work as well as usual. (Ozempic is used to help manage blood sugar levels.) Alcohol could also increase your risk of low blood sugar.

If you drink alcohol, talk with your doctor to learn how much, if any, is safe to consume while you’re using Ozempic.

Before you start treatment with Ozempic, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a chart of drugs that can interact with Ozempic. Keep in mind that this chart does not include all drugs that may interact with Ozempic. Some of these interactions are described in detail just below in “Drug interactions in depth.”

* To learn more about Ozempic’s side effects, see this article.

Here’s a closer look at certain drug interactions of Ozempic.

Insulins

Insulin medications may interact with Ozempic, increasing your risk of hypoglycemia (low blood sugar).

Interaction result. Both Ozempic and insulin medications can cause low blood sugar. Using these medications together could increase your risk of this side effect or cause severely low blood sugar.

Interaction explained. Both Ozempic and insulin medications work to lower your blood sugar. It’s possible for these drugs to work too well if they’re used together. This can drop your blood sugar to an unsafe level.

Examples of insulin drugs. Here are some insulin medications:

• insulin glargine (Lantus, Basaglar)
• insulin aspart (Novolog, Fiasp)
• isophane insulin human (Humulin N)

Steps you or your doctor may take. It’s important to be aware of the symptoms of low blood sugar so you and others know what to look for. Symptoms can include hunger, thirst, tremors, and shaking. Other possible symptoms are dizziness, weakness, sweating, and nausea. In severe cases, low blood sugar may cause confusion, fainting, seizure, or coma. Your doctor can advise you on how to treat low blood sugar.

When you first start treatment with Ozempic, your doctor may lower your dose of insulin. This can help decrease your risk of low blood sugar.

Your doctor may also lower your insulin dose if you have low blood sugar while using Ozempic in combination with your insulin medication. Or your doctor may suggest that you stop treatment with the insulin drug.

Sulfonylureas

Sulfonylurea medications may interact with Ozempic and increase your risk of low blood sugar. Sulfonylureas are a class of drugs that are used to manage blood sugar levels in people with type 2 diabetes.

Interaction result. Both Ozempic and sulfonylurea medications can cause low blood sugar. Using these medications together could increase your risk of this side effect or cause severely low blood sugar.

Interaction explained. Both Ozempic and sulfonylurea medications work to lower your blood sugar. It’s possible for these drugs to work too well if they’re used together. This can drop your blood sugar to an unsafe level.

Examples of sulfonylurea drugs. Here are some sulfonylureas that may interact with Ozempic:

• glipizide (Glucotrol XL)
• glimepiride (Amaryl)
• glyburide (Diabeta)

Steps you or your doctor may take. Be sure you and others know what the symptoms of low blood sugar are. To learn more, see “Steps you or your doctor may take” in “Insulins” above.

When you first start treatment with Ozempic, your doctor may lower the dose of your sulfonylurea.

Your doctor may lower your sulfonylurea dose if you experience low blood sugar while also using Ozempic. Or they may suggest you stop treatment with the sulfonylurea drug.

Certain oral medications

Ozempic may interact with certain oral medications.

Interaction result. If you take certain oral drugs at the same time as Ozempic, the oral drugs may not work as well as usual.

Interaction explained. Ozempic works to slow down how quickly your stomach empties. This can affect how well your body absorbs certain oral medications.

It’s not fully understood which medications Ozempic affects or how severe the interactions may be.

For some oral medications, slight changes in how the body absorbs them can affect how well they work or whether they work at all. For example, how well the seizure drug phenytoin (Dilantin) works can be significantly affected by small changes in how well your body absorbs the drug.

On the other hand, some other oral medications aren’t affected by small changes in how well your body absorbs the drugs. These medications are believed to be less likely to interact with Ozempic.

Examples of certain oral medications. Here are some oral medications that may interact with Ozempic:

• sitagliptin (Januvia)
• birth control pills, such as:
  • ethinyl estradiol/drospirenone (Yaz, Nikki, others)
  • ethinyl estradiol/levonorgestrel (Seasonale, Lo Simpesse, others)
  • levonorgestrel (Fallback Solo)
• digoxin (Lanoxin)

Steps you or your doctor may take. Your doctor may suggest that you take your doses of Ozempic and oral medication at different times. Or they may switch the oral medication to one that has a lower risk of being affected by Ozempic.

Ozempic may have other interactions, such as with supplements. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Ozempic.

Ozempic interactions with supplements

Before you start treatment with Ozempic, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.

Taking an alpha-lipoic acid supplement in combination with Ozempic may make you more likely to develop hypoglycemia (low blood sugar). If you’re taking the supplement, talk with your doctor before you begin treatment with Ozempic. They can help determine whether a supplement other than alpha-lipoic acid is right for you.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Ozempic interactions with herbs

Taking certain herbal supplements in combination with Ozempic may increase your risk of hypoglycemia (low blood sugar). Examples of these herbs include:

• prickly pear cactus
• bitter melon
• gymnema
• banaba
• white mulberry

If you take any of these herbal supplements, talk with your doctor before you begin using Ozempic. Your doctor can advise you on whether it’s safe to continue taking them.

Ozempic interactions with vitamins and minerals

Ozempic has not been reported to interact with vitamins, but the drug can interact with the mineral chromium. Using Ozempic and a chromium supplement may increase your risk of low blood sugar. Before using Ozempic, tell your doctor if you’re taking chromium. They can help determine the right treatment for you.

Ozempic and food

No foods or beverages have been reported to interact with Ozempic. This is despite the fact that several herbal and mineral supplements, which are also available in food or drink form, may interact with the drug.* These supplements include:

• prickly pear cactus
• chromium
• bitter melon
• gymnema
• banaba
• white mulberry

These substances would occur in much smaller amounts in food or beverage form than in supplement form.

Your doctor can help answer questions you may have about consuming certain foods and beverages during Ozempic treatment.

* To learn more, see “Ozempic interactions with herbs” and “Ozempic interactions with vitamins and minerals” above.

Ozempic and vaccines

Ozempic isn’t known to interact with any vaccines. Your doctor can provide you with more information about getting vaccines while you take Ozempic.

Ozempic and lab tests

Ozempic and lab tests aren’t known to interact with each other. If you have questions about having lab tests during Ozempic treatment, talk with your doctor.

Ozempic and cannabis or CBD

Cannabis (also called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Ozempic. However, as with any drug or supplement, talk with your doctor before taking cannabis in combination with Ozempic. The impact of cannabis may affect how well you stick to your Ozempic treatment plan.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Ozempic. Before you take Ozempic, be sure to talk with your doctor about your health history. Ozempic may not be the right treatment option for you if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Ozempic include:

• A type of thyroid cancer called medullary thyroid carcinoma. Doctors typically won’t prescribe Ozempic if you or a close family member has or has had medullary thyroid carcinoma. In fact, Ozempic has a boxed warning about the risk of thyroid cancer. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For more information, see the boxed warning at the beginning of this article.
• An endocrine condition called multiple endocrine neoplasia syndrome type 2. Doctors usually won’t prescribe Ozempic if you have or have had multiple endocrine neoplasia syndrome type 2 (MEN2). This rare endocrine condition can increase the risk of developing thyroid cancer. Ozempic has a boxed warning about the risk of thyroid cancer. A boxed warning is the most serious warning from the FDA. To learn more, see the boxed warning at the top of this article.
• Allergic reaction. If you’ve had an allergic reaction to Ozempic or any of its ingredients, your doctor will likely not prescribe Ozempic. To learn more, see “When to avoid Ozempic” above.
• Diabetic retinopathy. Before you begin Ozempic treatment, let your doctor know if you have or have had diabetic retinopathy. Ozempic may worsen this condition if you already have it or cause new symptoms to appear. Your doctor can tell you more about the risks and benefits of using Ozempic if you’ve ever had diabetic retinopathy.
• Kidney problems. There have been rare reports of kidney injury among people taking Ozempic since the drug was approved for use. If you have a kidney problem, such as chronic kidney disease, Ozempic may worsen your condition. Your doctor may prescribe the drug, but they’ll likely monitor your kidney health closely during treatment. And they’ll usually recommend stopping treatment with Ozempic if your kidney health worsens while you’re using the medication.
• Pancreas problems, including pancreatitis. Pancreatitis is a rare but serious side effect reported with Ozempic. It’s not known if the drug is safe to use in people who have pancreas problems or have had a pancreas problem, such as pancreatitis, in the past. Your doctor can tell you more about the risks and benefits of Ozempic if you have or have had pancreas problems.
• Gallbladder problems. Gallbladder problems, including gallstones, have been reported in people using Ozempic. If you have a gallbladder problem, such as cholecystitis, or have had them in the past, using Ozempic may worsen your condition. You can talk with your doctor to learn more about the risks and benefits of using Ozempic when you have or have had a gallbladder problem.
• Pregnancy. It’s not known whether it’s safe to take Ozempic while pregnant. Animal studies showed possible harm to the fetus, but animal studies don’t always predict how a drug will affect people. If you’re pregnant or planning to become pregnant, talk with your doctor. They can tell you more about the risks and benefits of certain diabetes treatments during pregnancy.
• Breastfeeding. It isn’t known whether it’s safe to breastfeed while you’re using Ozempic. Your doctor can tell you more about the benefits and drawbacks of breastfeeding while using the medication.

Here are some frequently asked questions about Ozempic and possible interactions.

What medications should not be taken with Ozempic?

Although some medications can interact with Ozempic, this doesn’t mean that Ozempic should never be used with these drugs.

Some medications can interact with Ozempic and lead to serious side effects. However, the dosage of these drugs can often be adjusted, which may allow them to be taken safely with Ozempic. To learn more, see “Drug interactions in depth” above. You can also talk with your doctor or pharmacist.

Are there certain people who should not take Ozempic?

Doctors typically will not prescribe Ozempic for certain people. This includes people with a personal or family history of certain thyroid cancers. It also includes people who have or have had multiple endocrine neoplasia syndrome type 2 (MEN2). This is a rare endocrine condition that can increase the risk of developing thyroid cancer. Ozempic has a boxed warning about the risk of thyroid cancer. . A boxed warning is the most serious warning from the Food and Drug Administration (FDA). To learn more, see the boxed warning at the top of this article.

Doctors also usually won’t prescribe Ozempic for people who have had an allergic reaction to the drug or any of its ingredients. For details, see “When to avoid Ozempic” above.

Your doctor can help determine whether Ozempic is right for you.

What should or should I not eat while taking Ozempic?

You can take your Ozempic doses without regard to food or meals. There haven’t been reports of food interactions with the drug. You may eat before taking Ozempic, but you don’t have to. Food isn’t expected to affect how well your body absorbs the medication or how well Ozempic works.

To help manage blood sugar levels, Ozempic is meant to be used in combination with exercise and a nutritious diet. Certain foods may have stronger effects on your blood sugar level. If you’d like to learn more about eating certain foods during treatment with Ozempic, talk with your doctor.

You can take certain steps to help prevent interactions with Ozempic. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or take cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the label of Ozempic and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions. (If Ozempic does not come with paperwork, you can ask your pharmacist to print a copy for you.) If this information is difficult to understand, ask your doctor or pharmacist to help explain it.

You can also help prevent interactions with Ozempic by taking it exactly as your doctor prescribes.

Besides learning about interactions, you may want to find out more about Ozempic. These resources might help:

• Overview of Ozempic. For a general overview of Ozempic, you can see this article.
• Side effects. If you’re interested in the side effects of Ozempic, see this article. Another option is to refer to the Ozempic prescribing information.
• Dosage specifics. To learn about the dosage of Ozempic, see this article.
• Drug comparison. Find out how Ozempic compares with Rybelsus, Trulicity, and Victoza.
• Cost. If you’d like to learn about Ozempic and cost, see this article.
• Facts about type 2 diabetes. To learn more about type 2 diabetes, see our diabetes hub.

Disclaimer: Medical News Today 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.