Ozempic interactions with alcohol and other medications

Contraindications: Who should not use Ozempic?

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:

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 a type of thyroid cancer called medullary thyroid carcinoma (MTC).

In fact, Ozempic has a boxed warning about the risk of thyroid cancer. For more information, see the “Boxed warning” box near the beginning of this article.

Personal history of multiple endocrine neoplasia syndrome type 2 (MEN2)

Doctors usually won’t prescribe Ozempic if you have or have had 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. For more information, see the “Boxed warning” box near the beginning of this article.

Previous allergic reaction to Ozempic or any of its ingredients

If you’ve had an allergic reaction to Ozempic or any of its ingredients, your doctor will likely not prescribe this drug for you, as it could cause another allergic reaction. They can recommend other treatments that may be better options for you.

Note: Before starting Ozempic, it’s important to tell your doctor if any of these contraindications apply to you to help them determine if Ozempic is safe for you to take.

Can I safely drink alcohol on Ozempic?

There is no direct interaction between Ozempic and alcohol. However, alcohol can lower or raise your blood sugar level. This means alcohol could make Ozempic less effective since this medication is used to help manage blood sugar levels. Alcohol could also increase your risk of hypoglycemia (low blood sugar).

If you drink alcohol, talk with your doctor to learn how much, if any, is safe to consume during treatment with Ozempic.

Ozempic interactions with other medications

Before starting Ozempic treatment, tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. Sharing this information with them may help to prevent possible interactions.

The following table lists drugs that can interact with Ozempic. Some of these interactions are described in detail in the next section, “Drug interactions in depth.” Keep in mind that this table does not include all drugs that may interact with Ozempic.

Drug interactions in depth

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

Insulins

You can take insulin with Ozempic, but be sure to discuss your dosages with your doctor to avoid hypoglycemia (low blood sugar).

Interaction result: Both Ozempic and insulin medications work to lower your blood sugar and can cause hypoglycemia. Using these medications together could increase your risk of this side effect or cause it to be severe.

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.

If you have hypoglycemia while using insulin in combination with Ozempic, your doctor may lower your insulin dose or have you stop taking it altogether.

Sulfonylureas

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

Interaction result: Both Ozempic and sulfonylureas work to lower your blood sugar and can cause hypoglycemia. Using these medications together could increase your risk of this side effect or cause it to be severe.

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

• glipizide (Glucotrol XL)
• glimepiride
• glyburide (DiaBeta)

Steps you or your doctor may take: Be sure you and others know what the symptoms of low blood sugar are. (See the previous “Insulins” section for details.)

When you first start Ozempic, your doctor may lower your sulfonylurea dose. And if you have low blood sugar during treatment with both drugs, your doctor may lower your sulfonylurea dose or have you stop taking the sulfonylurea altogether.

Certain oral medications

Ozempic may interact with certain oral medications.

Interaction result: If you take certain oral drugs while using Ozempic, they may not work as well as usual, or their levels in your blood could become unpredictable.

Interaction explained: Ozempic works by slowing down how quickly your stomach empties (called gastric emptying). This can cause a backup in your digestive tract, delaying or changing how your body absorbs other drugs.

According to the latest 2025 clinical data, this effect is greatest after your very first dose of Ozempic or when your doctor increases your dose. As your body gets used to the drug, stomach emptying usually returns to a more normal pace.

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.

Examples of 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)
• warfarin (Coumadin, Jantoven)
• levothyroxine (Levoxyl, Synthroid, Unithroid)

Steps you or your doctor may take: Your doctor may suggest more frequent blood tests, specifically during the first few weeks after you start Ozempic or change your dose. These include tests to check your:

• thyroid-stimulating hormone (TSH) levels, if you take thyroid drugs
• international normalized ratio (INR), if you take warfarin

Note: If you’re taking the oral tablet version of semaglutide, these tablets must be taken at least 30 minutes before any other oral medications to ensure everything is absorbed correctly.

Medical Perspective

How will a doctor monitor a patient’s health throughout long-term GLP-1 therapy?

“A doctor will monitor things like weight, kidney function, and blood sugar (usually with an A1c test) to see how a patient is responding to the drug and if there are any negative effects as a result of the drug.”

— Philip Ngo, PharmD

Learn more about side effects of Ozempic.

_{Quotes represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.}

Ozempic and other interactions

Ozempic may have other interactions, such as with supplements. Keep in mind that the following information does not include all other possible interactions with Ozempic.

Talk with your doctor or pharmacist if you have questions about interactions with Ozempic.

Ozempic interactions with supplements

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

Taking an alpha-lipoic acid supplement in combination with Ozempic may make you more likely to develop low blood sugar. If you take this supplement, talk with your doctor before starting Ozempic. They can determine whether a supplement other than alpha-lipoic acid is right for you.

Ozempic interactions with herbs

Taking certain herbal supplements in combination with Ozempic may increase your risk of 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 starting Ozempic.

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.

Ozempic and food

No foods or beverages have been reported to interact with Ozempic. However, several herbal and mineral supplements, which are also available in food or drink form, may interact with the drug.

These supplements (as previously noted) include chromium, prickly pear cactus, bitter melon, gymnema, banaba, and white mulberry. These substances occur in much smaller amounts in food or beverage than in supplements.

Ozempic and vaccines

Ozempic isn’t known to interact with any vaccines.

Ozempic and lab tests

Ozempic and lab tests aren’t known to interact with each other.

Ozempic and cannabis or CBD

Cannabis (often 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.

Ozempic and health-related interactions

Certain medical conditions and other factors may increase the risk of interactions with Ozempic. Before starting this medication, be sure to talk with your doctor about your health history. They can determine if Ozempic is the right treatment option for you based on various factors affecting your health.

Health conditions or factors that might interact with Ozempic include:

• 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. For more information, see the “Boxed warning” box near the beginning of this article.
• MEN2: Doctors usually won’t prescribe Ozempic if you have or have had MEN2. This rare endocrine condition can increase the risk of thyroid cancer. Ozempic has a boxed warning about the risk of thyroid cancer. For more information, see the “Boxed warning” box near the beginning of this article.
• Severe digestive system problems: Because Ozempic slows your digestion, it can lead to severe gastrointestinal issues in some people. In addition to gastroparesis (severely slowed digestion), the FDA has highlighted risks of intestinal obstruction (ileus) and severe constipation, including fecal impaction (hardened stool that stays stuck in the rectum). If you have a history of severe bowel issues, talk with your doctor before starting Ozempic.
• Dehydration from digestive system side effects: Since the drug came on the market, there have been reports of acute kidney injury and worsening of chronic kidney failure in people using Ozempic. This most often happens when a person becomes dehydrated due to severe nausea, vomiting, or diarrhea. If you experience these side effects, your doctor may need to monitor your kidney function closely or adjust your dose to prevent permanent kidney damage.
• Allergic reaction: If you’ve had an allergic reaction to Ozempic or any of its ingredients, your doctor will likely not prescribe Ozempic for you.
• Diabetic retinopathy: Before starting Ozempic, tell your doctor if you have or have had diabetic retinopathy. Ozempic may worsen this condition if you already have it or cause new symptoms to appear.
• Pancreas problems, including pancreatitis: Pancreatitis (inflammation of the pancreas) is a serious side effect reported with Ozempic. If your doctor suspects you have pancreatitis, you must stop using Ozempic immediately. If pancreatitis is confirmed, the medication should not be restarted. It’s still not known if Ozempic is safe for people who have had pancreatitis in the past.
• 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 one in the past, using Ozempic may worsen your condition.
• Upcoming surgery: In some people who have general anesthesia or deep sedation for surgery, Ozempic may cause pulmonary aspiration (accidental inhalation of liquid or other substances). If you have surgery scheduled, let your doctor know before starting Ozempic. If you need surgery while using Ozempic, inform your healthcare team that you take this drug before your surgery.
• Pregnancy: It’s not known whether it’s safe to use Ozempic while pregnant. Animal studies showed possible harm to the fetus, but animal studies don’t always predict how a drug will affect humans. Due to the drug’s long “washout period” (how long it stays in your system), you should stop Ozempic treatment at least 2 months before a planned pregnancy. This is especially important given recent reports of unintended pregnancies (“Ozempic babies”) in people using oral contraceptives. (This can cause problems because the fetus is exposed to a drug that could potentially cause harm before you even know you’re pregnant.) If you’re pregnant or planning a pregnancy, talk with your doctor.
• Breastfeeding: It isn’t known whether it’s safe to breastfeed a child while you’re using Ozempic. Your doctor can tell you more about the benefits and drawbacks of breastfeeding while using this medication.

FAQ about Ozempic and interactions

Preventing interactions

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 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’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 doesn’t come with paperwork, you can ask your pharmacist to print a copy for you. If you need help reading or understanding this information, ask your doctor or pharmacist.

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