Key takeaways

  • If you take any oral medications (by mouth), Ozempic can make the medication take longer to start working. Your doctor can recommend whether you might need your dosage adjusted.
  • Some antibiotics can interact with Ozempic, such as amoxicillin and clarithromycin. Insulin and diabetes drugs called sulfonylureas can also interact with Ozempic.
  • Your doctor may recommend avoiding some supplements with Ozempic: Gymnema, prickly pear, bitter melon, and fenugreek.

Ozempic (semaglutide) is used for the certain conditions, including managing blood sugar levels in adults with type 2 diabetes.

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.

Ozempic has a boxed warning. 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. To learn more, see the “When should I avoid Ozempic?” section.

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). (MEN 2 is a rare genetic disorder that may cause thyroid tumors.)

This is because Ozempic has a boxed warning for the risk of thyroid tumors and thyroid cancer. In animals, Ozempic was found to increase the risk of thyroid tumors. It’s unknown whether Ozempic increases the risk of such tumors in humans. To learn more about this warning, talk with your doctor.

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 nameDrug examplesWhat 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

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:

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.

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.

There are currently no reports of Ozempic interacting with vitamins, food, vaccines, or lab tests. But this doesn’t mean that 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.

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.

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). Ozempic has a boxed warning for the risk of thyroid tumors and thyroid cancer. See the “When should I avoid Ozempic?” section for details.

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.

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.

Yes, it should be safe to use Ozempic with antidepressants. There were no reports of interactions between Ozempic and antidepressant medications, amitriptyline.

But, Ozempic can slows the emptying of your stomach which may cause oral medications, like a lot of antidepressants, to take longer to start working.

Talk with your doctor about whether antidepressants are safe for you to take during your treatment with Ozempic.

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.

Before starting treatment with Ozempic, 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 label and other paperwork that may come with the drug.

Disclaimer: While Healthline strives for factual, comprehensive, and current information, this article is not a substitute for a licensed healthcare professional’s expertise. Always consult a doctor before taking or discontinuing any medication. Drug information is subject to change and may not cover all uses, directions, precautions, warnings, interactions, reactions, or adverse effects. The lack of a warning does not guarantee a drug’s safety, effectiveness, or appropriateness for all patients or specific uses. Learn more about our approach to content integrity.