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TRUTH IN PEPTIDES
Peer Reviewed

Semaglutide — Interactions & Safety Profile

3 contraindications2 known interactions⚠ Pregnancy warning

Contraindications

Personal or family history of medullary thyroid carcinoma (MTC)

GLP-1 agonists caused thyroid C-cell tumours in rodents. Contraindicated if personal or family history of MTC.

Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)

MEN 2 predisposes to medullary thyroid carcinoma.

History of pancreatitis

GLP-1 agonists associated with acute pancreatitis in post-marketing reports. Use with extreme caution.

Drug Interactions

Insulin / SulfonylureasSeriousmajor interaction

Increased risk of hypoglycaemia when combined.

Mechanism: Additive glucose-lowering effect.

Reduce insulin or sulfonylurea dose when initiating semaglutide.

Oral medications (narrow therapeutic index)Moderatemoderate interaction

Slowed gastric emptying may delay absorption of co-administered oral medications.

Mechanism: Delayed gastric emptying.

Monitor oral drug levels (e.g. warfarin, levothyroxine, oral contraceptives). Clinically significant interactions rare but possible.

Monitoring Required

  • HbA1c (if diabetic) every 3-6 months
  • Renal function (eGFR) periodically
  • Signs of pancreatitis (persistent severe abdominal pain)
  • Thyroid examination if symptoms develop

Pregnancy & Nursing

Contraindicated. Teratogenic in animal studies. Discontinue ≥2 months before planned pregnancy.

Pending physician review — consult your provider before use.

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