6 Wegovy Interactions You Should Know About
Key takeaways:
Wegovy (semaglutide) is a once-weekly injection for weight loss. It can also lower the risk of serious cardiovascular problems in people with heart disease and a larger body size. People with and without diabetes may be prescribed Wegovy.
Wegovy may affect the way your body absorbs oral medications. And if you have Type 2 diabetes, Wegovy can interact with insulin, sulfonylureas, and meglitinides. This can result in your blood glucose (sugar) levels dropping too low.
Keep an updated list of all of your medications to share with your healthcare team. This will help them spot possible interactions before they happen.
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Table of contents
Wegovy (semaglutide) is a once-weekly injectable medication approved for weight loss and lowering the risk of serious cardiovascular problems in certain people. Since it’s an injection, you may not think about drug interactions while using it. But if you have Type 2 diabetes or take other medications by mouth, you’re not entirely off the hook.
While it’s not approved for diabetes, Wegovy can affect blood glucose (blood sugar) levels. It also slows down how fast your stomach empties. Both of these effects can lead to possible interactions. Below, we review six potential Wegovy interactions and how to manage them.
1. Insulin
Insulin is one of the oldest medications used to treat diabetes. It can be taken in short-acting and long-acting formulations to manage blood sugar levels. But if you take too much insulin, hypoglycemia (low blood sugar) can occur because insulin lowers your blood sugar levels.
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When used alone, low blood sugar episodes with Wegovy are rare. This is because Wegovy stimulates insulin release, but mostly only after a meal. This is different from the way insulin works. Insulin can lower blood sugar even if you haven’t eaten.
If you have Type 2 diabetes, it’s possible that you may be prescribed Wegovy to help with weight loss. But if you’re also taking insulin, this combination can raise your risk of low blood sugar. To reduce this risk, your prescriber may first lower your insulin dose.
If your blood sugar levels drop too low, you may have symptoms like shakiness, dizziness, and nausea. If this happens after starting this combination, check your blood sugar levels. Follow the instructions you’ve been given to bring them back up.
Tell your prescriber if you’re having frequent hypoglycemia episodes with insulin and Wegovy. They may have you adjust your insulin dosage.
2. Sulfonylureas
Sulfonylureas are a class of oral diabetes medications. Examples include glipizide (Glucotrol XL) and glyburide (Diabeta, Glynase). Sulfonylureas work by signaling your pancreas to release more insulin. This happens regardless of food intake. When they’re combined with Wegovy, there’s a greater chance of low blood sugar.
Like insulin, your sulfonylurea dosage may be adjusted ahead of time to prevent low blood sugar. But if your blood sugar levels are dropping too low after starting Wegovy, keep your prescriber informed. Further dosage adjustments could be needed.
3. Meglitinides
Meglitinides (“glinides”) are another group of oral diabetes medications that can interact with Wegovy. Examples include repaglinide and nateglinide. Meglitinides help your body release insulin, similar to sulfonylureas. But they’re taken at the beginning of meals and only work for a short period of time.
Wegovy and meglitinides can both lower blood sugar levels, which may raise the risk of hypoglycemia when taken together. Be sure to check your blood sugar levels as directed and let your prescriber know if it’s dropping too low. They may need to adjust your meglitinide dosage.
4. Oral medications
One of the ways Wegovy works is by slowing gastric emptying. This means that food, along with other contents, leaves the stomach more slowly. This can add to the helpful effects of feeling full so you lose weight.
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But, slowed gastric emptying can also affect the way your body absorbs oral medications. This may not be a problem for most medications. But you’ll want to be cautious if you’re taking medications that need frequent monitoring to make sure they’re safe and effective, such as warfarin. Your healthcare team can look over your medication list and adjust dosages as needed.
5. Other weight-loss medications
Besides Wegovy, there are other injectable and oral medications for weight loss. Examples include:
Saxenda (liraglutide)
Zepbound (tirzepatide)
Contrave (naltrexone / bupropion)
Qsymia (phentermine / topiramate ER)
Wegovy hasn’t been studied in combination with other weight-loss medications. So, it’s not known if it’s safe to take them together. If you’re not seeing the results you want with Wegovy, talk to your prescriber before adding another weight-loss medication into the mix. This includes over-the-counter (OTC) supplements such as berberine.
6. Alcohol
There’s no direct interaction between alcohol and Wegovy. But alcohol can potentially worsen Wegovy side effects, such as nausea and indigestion. It may also offset some of Wegovy’s benefits, including weight loss and heart protection.
Alcohol may not be entirely off limits with Wegovy. However, it’s best to discuss how much you drink with your healthcare team. They can provide guidance for how much alcohol (if any) is OK for your specific situation.
Frequently asked questions about Wegovy interactions
You may have questions about whether it’s safe to take Wegovy with other medications that aren’t covered above. Below, we cover a few frequently asked questions about Wegovy interactions.
Wegovy isn’t known to directly interact with blood pressure medications. However, Wegovy has been shown to lower blood pressure, whether you have high blood pressure or not. And if you’re taking medications to lower your blood pressure, Wegovy may cause it to drop too low (hypotension). If this happens, you may feel dizzy or lightheaded.
What’s more, a blood pressure medication class called angiotensin-converting enzyme (ACE) inhibitors can make your body more sensitive to insulin. When ACE inhibitors are taken with Wegovy, there may be a higher risk of low blood sugar.
Tell your healthcare team if your blood pressure or blood sugar levels are getting too low during treatment. They may need to adjust your medications.
Yes. You can take Wegovy and ADHD medications, including stimulants like Adderall, together. But if you combine Wegovy and Adderall, there are a few things to keep in mind.
One side effect of Adderall and other stimulants is loss of appetite. Wegovy can also lessen your appetite. If you take Adderall and Wegovy together, be sure you’re eating enough nutrient-dense foods if your appetite is significantly reduced. Your healthcare team can help formulate a meal plan that works for you.
The extended-release version of Adderall is formulated in a specific way to release the medication over time. And since Wegovy can slow down gastric emptying, this effect may cause you to absorb your Adderall dose differently. For some people, your usual Adderall dose may not work as well with Wegovy. For others, its effects may last longer than usual. Talk to your prescriber if you notice any changes after starting Wegovy.
There’s no known drug interaction between Wegovy and levothyroxine. But Wegovy can delay stomach emptying, especially within the first few months. In theory, this could interfere with how you absorb levothyroxine and lead to changes in your thyroid hormone levels. In fact, Rybelsus, an oral form of semaglutide, can interact with levothyroxine.
Your healthcare team may monitor your thyroid levels more closely after starting Wegovy.
When should you contact your prescriber about Wegovy interaction?
Contact your prescriber if you have any concerns about possible Wegovy interactions. In many cases, they can be found and managed before they become a problem.
If you’re taking Wegovy with diabetes medications, drops in blood glucose could signal a possible drug interaction. If you’re experiencing hypoglycemia episodes, be sure to let your healthcare team know. You may need an adjustment to your medication regimen.
It’s best to always have an updated medication list that includes prescription and OTC medications, plus supplements. Share it with your healthcare team anytime you start or stop a new medication.
The bottom line
Wegovy (semaglutide) can interact with medications that lower blood glucose (sugar), such as insulin, sulfonylureas, and meglitinides. It may also affect how oral medications are absorbed. Some Wegovy interactions can cause hypoglycemia (low blood sugar). This needs to be managed according to the directions given to you by your healthcare team.
If you have any questions about how any medications you’re taking might interact with Wegovy, contact your prescriber or pharmacist.
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References
Kennedy, C., et al. (2023). The effect of semaglutide on blood pressure in patients without diabetes: A systematic review and meta-analysis. Journal of Clinical Medicine.
Marso, S. P., et al. (2016). Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. The New England Journal of Medicine.
Novo Nordisk. (2024). Wegovy semaglutide injection 2.4mg [package insert].
Yao, J., et al. (2021). Angiotensin-converting enzyme inhibitors versus angiotensin II receptor blockers on insulin sensitivity in hypertensive patients: A meta-analysis of randomized controlled trials. PloS One.
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