Rybelsus interactions

Before you start treatment with Rybelsus, 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. (To learn whether Rybelsus interacts with supplements, herbs, or vitamins, see the “Rybelsus and other interactions” section below.)

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

Here’s a table of drugs that can interact with Rybelsus. Keep in mind that this table doesn’t include all drugs that may interact with Rybelsus. Some of these interactions are described in detail just below in “Drug interactions in depth.”

Sometimes, certain factors or conditions could prevent your doctor from prescribing Rybelsus due to the risk of harm. These are known as contraindications. The contraindications of Rybelsus include:

Having multiple endocrine neoplasia syndrome type 2 (MEN2) or medullary thyroid carcinoma

Doctors typically won’t prescribe Rybelsus for people with specific factors that raise their risk of thyroid cancer.

These factors include:

• a personal history of MEN2, which is a rare genetic condition
• a personal or family history of medullary thyroid carcinoma, which is a rare type of thyroid cancer

This is because Rybelsus 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 details, see “Boxed warning” at the beginning of this article.

If you have MEN2 or medullary thyroid carcinoma, tell your doctor before taking Rybelsus. They’ll likely prescribe a treatment other than Rybelsus for your condition.

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

If you have had an allergic reaction to Rybelsus or any of its ingredients, your doctor will likely not prescribe Rybelsus. Taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be safe for you.

Note: Before you start treatment with Rybelsus, it is important to tell your doctor if these contraindications apply to you. They can determine whether to prescribe Rybelsus.

There aren’t any known interactions between Rybelsus and alcohol. However, your doctor may advise you to avoid or limit alcohol consumption during Rybelsus treatment.

This is because Rybelsus helps manage blood sugar levels in adults with type 2 diabetes. And alcohol can affect blood sugar levels. So, consuming alcohol during Rybelsus treatment can make it hard to tell if the drug is working for your condition.

If you have questions about drinking alcohol while taking Rybelsus, talk with your doctor.

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

Corticosteroids

Doctors prescribe corticosteroids to ease inflammation.

Interaction result. Taking Rybelsus with corticosteroids may make Rybelsus less effective for managing blood sugar levels.

Interaction explained. Doctors prescribe Rybelsus to help manage blood sugar levels in people with type 2 diabetes. Corticosteroids may raise blood sugar levels. So, taking corticosteroids with Rybelsus could make it harder for Rybelsus to manage your blood sugar.

Examples of corticosteroids. Here are some corticosteroids that may interact with Rybelsus:

• dexamethasone (Hemady)
• prednisone (Rayos)
• methylprednisolone (Medrol)

Steps you or your doctor may take. If you need to take corticosteroids while taking Rybelsus, talk with your doctor. Be sure they know you are taking Rybelsus. They can determine whether it is safe to take these medications together.

If your doctor prescribes Rybelsus with a corticosteroid, they may temporarily adjust your Rybelsus dosage. Taking these drugs together may help manage your blood sugar levels better. To learn more about the dosage of Rybelsus, see this article.

If you have other questions about Rybelsus and corticosteroids, talk with your doctor or pharmacist.

Insulin

Doctors prescribe insulin to help manage blood sugar levels in people with type 1 or type 2 diabetes.

Interaction result. Taking Rybelsus while using insulin can increase the risk of low blood sugar with either drug.

Interaction explained. Both Rybelsus and insulin can lower blood sugar levels when used on their own. Taking Rybelsus in combination with insulin may lower blood sugar even further.

Examples of insulins. Here are some insulins that may interact with Rybelsus:

• insulin glargine (Basaglar, Lantus, Toujeo)
• insulin detemir (Levemir)
• insulin lispro (Admelog, Humalog, Lyumjev)

Steps you or your doctor may take. If your doctor prescribes Rybelsus with insulin, they may prescribe a lower insulin dosage. Doing so may reduce your risk of having low blood sugar when you use these drugs together.

If you take Rybelsus with insulin, watch for symptoms of low blood sugar. Examples include headache, sweating, and shaking.

Your doctor will recommend what to do if you have symptoms of low blood sugar. For example, they may advise you to eat at least 15 grams of carbohydrates to help raise your blood sugar level. Sources of carbohydrates include fruit juice, hard candies, and glucose tablets. Keep in mind that diet sodas and sugar-free candies will not help manage low blood sugar.

Severely low blood sugar may cause you to lose consciousness. If you have low blood sugar symptoms that seem severe or life threatening, you or a bystander should call 911 or a local emergency number immediately.

If you have other questions about taking Rybelsus with insulin, talk with your doctor or pharmacist.

Warfarin

Doctors prescribe warfarin (Jantoven) to help treat or prevent blood clots in certain situations.

Interaction result. Taking Rybelsus with warfarin may increase the risk of side effects of warfarin.

Interaction explained. Rybelsus may cause your stomach to empty its contents more slowly than usual. This can increase the amount of warfarin in your body, which may raise your risk of side effects from warfarin.

Steps you or your doctor may take. Before starting Rybelsus treatment, tell your doctor if you take warfarin. They’ll recommend whether it is safe to take these medications together.

If your doctor prescribes Rybelsus with warfarin, they’ll likely have you take Rybelsus at least 30 minutes before warfarin. Doing so can help lower the risk of Rybelsus affecting the drug.

If you have other questions about Rybelsus and warfarin, talk with your doctor or pharmacist.

Rybelsus may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Rybelsus.

Rybelsus interactions with supplements

Rybelsus may interact with the following supplements:

• garlic
• DHEA
• green tea

Rybelsus and the supplements listed above can decrease blood sugar levels. Taking Rybelsus with any of these supplements may increase your risk of having hypoglycemia (low blood sugar). Due to this, your doctor may recommend avoiding garlic, DHEA, and green tea supplements while taking Rybelsus.

Sometimes, your doctor may tell you it is safe to take Rybelsus with supplements that decrease your blood sugar. If so, your doctor may adjust your Rybelsus dosage to help prevent hypoglycemia. For details about the dosage of Rybelsus, see this article.

Before starting treatment with Rybelsus, tell your doctor and pharmacist which supplements, herbs, and vitamins 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.

Rybelsus and herbs

There are no specific reports of herbs interacting with Rybelsus. However, that doesn’t mean herbal interactions won’t occur or be recognized in the future. Because of this, it is important to check with your doctor or pharmacist before taking any of these products during Rybelsus treatment.

Rybelsus interactions with vitamins and minerals

There are no specific reports of vitamins interacting with Rybelsus. However, Rybelsus may interact with a mineral called chromium. Some people take this mineral to help manage their blood sugar levels.

If you take chromium with Rybelsus, both products can decrease your blood sugar. This can increase your risk of having low blood sugar. Due to this, your doctor may recommend avoiding chromium supplements while taking Rybelsus.

If you do take chromium supplements with Rybelsus, your doctor may adjust your Rybelsus dosage to help prevent low blood sugar. For details about the dosage of Rybelsus, see this article.

Keep in mind that some multivitamins may also contain minerals, such as chromium. Talk with your doctor to determine which multivitamin is best for you.

Rybelsus interactions with food

Rybelsus can interact with foods and beverages. Consuming foods or drinks with Rybelsus can make the drug less effective for your condition.

For this reason, it is important to take Rybelsus at least 30 minutes before your first food or beverage of the day. However, it should be safe to take Rybelsus with about 4 ounces of water to help you swallow the tablet.

In addition, Rybelsus may interact with green tea. This is because Rybelsus and green tea can decrease blood sugar levels. Taking Rybelsus with green tea may increase your risk of having low blood sugar. Due to this risk, your doctor may advise you to avoid or limit green tea consumption during Rybelsus treatment.

Although garlic supplements* may interact with Rybelsus, it should be safe to eat garlic while taking this drug. The amount of garlic in food is usually small and much less than in a garlic supplement.

If you have additional questions or want more information about consuming certain foods or beverages during Rybelsus treatment, talk with your doctor.

* For details, see “Rybelsus interactions with supplements” above.

Rybelsus and vaccines

There are no known interactions between Rybelsus and vaccines. Talk with your doctor or pharmacist to see whether you are due for any vaccines.

Rybelsus and lab tests

Rybelsus is not known to interact with any lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor.

RYBELSUS AND CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Rybelsus. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Rybelsus. The impact of cannabis may affect how well you stick to your Rybelsus 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 Rybelsus. Before you take this drug, be sure to talk with your doctor about your health history. Rybelsus may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Rybelsus include:

• Kidney problems. Before taking Rybelsus, tell your doctor if you have a kidney problem, such as kidney failure. The drug may cause digestive issues, leading to dehydration and worsening kidney conditions. If you have a kidney problem, your doctor can tell you whether it is safe to take Rybelsus.
• Diabetic retinopathy. If you have a vision problem called diabetic retinopathy, tell your doctor before taking Rybelsus. The drug may worsen this condition. Your doctor will watch for vision changes during Rybelsus treatment. They may also advise you to visit an eye doctor to monitor this vision problem.
• Pancreatitis. If you have had pancreatitis, be sure to tell your doctor before starting Rybelsus treatment. You may have a higher risk of pancreatitis as a side effect of the drug. If you have had pancreatitis, your doctor can tell you whether it is safe to take Rybelsus.
• Gallbladder problems. Before taking Rybelsus, let your doctor know if you have gallbladder problems, such as gallstones. This medication may cause gallbladder problems, including gallstones. If you already have gallbladder issues, taking Rybelsus may worsen your condition.
• Allergic reaction. If you have had an allergic reaction to Rybelsus or any of its ingredients, your doctor will likely not prescribe Rybelsus. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.
• Breastfeeding. It is unknown whether it’s safe to take Rybelsus while breastfeeding. There is not enough information to determine whether the drug passes into breast milk or what effects Rybelsus may have on a child who is breastfed. To be safe, it’s recommended to avoid breastfeeding while you are taking Rybelsus. If you are breastfeeding or planning to, talk with your doctor before using Rybelsus. They can talk with you about treatment options and ways to feed your child.
• Pregnancy. There haven’t been enough clinical trials to determine whether Rybelsus is safe to use while pregnant. Animal studies show that the drug may cause congenital anomalies (commonly known as birth defects) or pregnancy loss. However, it is important to note that animal studies do not always indicate what may happen in humans. If you are pregnant or planning to become pregnant, tell your doctor before starting Rybelsus. They can advise you on the right treatment plan for you.
• Risk of thyroid cancer. Rybelsus has a boxed warning about the risk of thyroid cancer. This is a serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous. For details, see the boxed warning at the top of this article.

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

How do the interactions of Rybelsus vs metformin compare?

Rybelsus and metformin (Fortamet, Glumetza) have some of the same interactions but some different ones as well.

For example, both Rybelsus and metformin may interact with corticosteroids and certain diuretics. However, Rybelsus is known to interact with bismuth subsalicylate (Pepto Bismol), while metformin is not.

To learn more about how the interactions of Rybelsus and metformin compare, talk with your doctor or pharmacist.

Can you take metformin and Rybelsus together?

Yes, if your doctor recommends it. There aren’t any reports of Rybelsus interacting with metformin.

However, keep in mind that both Rybelsus and metformin can cause low blood sugar. You might be at increased risk if you take these medications together.

Metformin is used to treat diabetes, and Rybelsus is known to interact with other diabetes drugs. Examples include insulin and sulfonylureas. To learn more, see the “Rybelsus interactions with other medications” and “Drug interactions in depth” sections above.

If you have other questions about taking Rybelsus with metformin, talk with your doctor or pharmacist.

Is it safe to take other oral medications with Rybelsus?

Yes, if your doctor recommends it. Oral medications may include any tablet, capsule, or liquid solution that you take by mouth.

Ryblesus may affect your body’s ability to absorb other oral medications. For this reason, your doctor may closely monitor the effects of other oral drugs while you are taking Rybelsus. They may also recommend that you take Rybelsus at least 30 minutes before other oral medications. Doing so can help lower the risk of Rybelsus affecting other oral drugs.

Rybelsus is known to interact with specific oral medications. To learn more, see the “Rybelsus interactions with other medications” and “Drug interactions in depth” sections above.

If you have other questions about taking Ryblesus with other oral medications, talk with your doctor or pharmacist.

You can take certain steps to help prevent interactions with Rybelsus. 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 use 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 is also important to read the Rybelsus label 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 Rybelsus does not come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

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

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

• Overview of Rybelsus. For a general overview of Rybelsus, you can see this article.
• Side effects. For information on the side effects of Rybelsus, see this article or refer to the Rybelsus prescribing information.
• Dosage specifics. To learn about the dosage of Rybelsus, see this article.
• Drug comparison. Learn how Rybelsus compares with Ozempic and metformin in the Rybelsus vs. metformin section of this article.
• Cost. If you’d like to learn about Rybelsus 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.