Navigating Your Health: What Medications to Consider with Ozempic

Last reviewed: July 1, 2026

Last updated: July 1, 2026

Written by: Jay Hastings, CEO of PlexusDx

Jay Hastings is the CEO of PlexusDx, a precision health company focused on genetic testing, blood biomarker insights, and personalized wellness recommendations. He has more than 20 years of experience across healthcare innovation, genomics, laboratory operations, healthcare investing, and strategic finance.

Medically reviewed by: Jayden Lee, PharmD, EMBA

Jayden Lee, PharmD, EMBA, is the PlexusDx Medical Science Liaison with a PharmD and MBA specializing in pharmacogenomics and clinical product development, with a proven ability to bridge the gap between genomic research and practical patient outcomes. Dr. Lee has more than 10 years of professional experience in clinical pharmacy, academia, and research.

The medications that matter most alongside Ozempic are the ones your prescriber and pharmacist already need to know about, and the Ozempic prescribing information names two categories explicitly: insulin or insulin secretagogues such as sulfonylureas, which raise the risk of hypoglycemia when combined with semaglutide, and oral medications generally, because Ozempic delays gastric emptying and can therefore affect how other drugs are absorbed. Beyond those two, the label's warnings section flags situations rather than specific drug names, including surgery under general anesthesia or deep sedation. None of this is a checklist a reader can apply alone, and that is the point.

Start With the Full List, Not a Short One

Ozempic is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus, to reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes and established cardiovascular disease, and to reduce the risk of sustained eGFR decline, end-stage kidney disease and cardiovascular death in adults with type 2 diabetes and chronic kidney disease. It has no weight-management indication.

People who meet those criteria typically take several other medications. Metformin, SGLT2 inhibitors, antihypertensives, statins, thyroid replacement, anticoagulants and over-the-counter analgesics are all common in this population. The clinically useful action is to hand a prescriber and pharmacist a complete list, including supplements and anything taken intermittently, rather than to screen individual pairs against an article.

Insulin and Insulin Secretagogues Are the Named Interaction

Section 7.1 of the Ozempic label states that the medication stimulates insulin release in the presence of elevated blood glucose concentrations, and that patients receiving it in combination with an insulin secretagogue such as a sulfonylurea, or with insulin, may have an increased risk of hypoglycemia, including severe hypoglycemia. The same concern appears in the warnings and precautions section, and the label notes that when therapy is initiated, reducing the dose of the concomitant insulin secretagogue or insulin may be considered to mitigate that risk.

That is a prescriber action, not a patient one. Adjusting insulin or a sulfonylurea without clinical supervision is dangerous in both directions. What a person can do is make sure the prescriber writing the semaglutide prescription knows exactly what glucose-lowering therapy is already in place, particularly if different clinicians manage different parts of their care.

Delayed Gastric Emptying and Oral Medications

Section 7.2 states that Ozempic causes a delay of gastric emptying and thereby has the potential to impact the absorption of concomitantly administered oral medications. The label reports that clinical pharmacology trials did not show effects on oral medication absorption to a clinically relevant degree, while still noting that caution is warranted.

The nuance worth carrying is that a drug can be affected in either direction. Slower stomach emptying can delay the peak concentration of a rapidly absorbed medication, and in some cases can change total exposure. Whether that matters depends entirely on the drug in question. For a once-daily medication with a wide safety margin, a shifted absorption curve is usually irrelevant. For a drug where small changes in blood level have clinical consequences, it is not.

Narrow Therapeutic Index Drugs Deserve a Direct Conversation

The related semaglutide labeling for Wegovy is more prescriptive on this point, advising that increased clinical or laboratory monitoring be considered when semaglutide is used concomitantly with other oral medications that have a narrow therapeutic index or that require clinical monitoring. That labeling also reports a drug interaction study with the semaglutide tablet in which total thyroxine exposure was increased by 33%.

That specific finding comes from the oral semaglutide formulation, not from the injection, and it should not be generalized beyond what was studied. Its practical value is as an illustration: interactions with GLP-1 receptor agonists are more often about absorption timing and monitoring than about drugs that cannot be combined at all. Levothyroxine, warfarin, antiepileptics, immunosuppressants and lithium are the kinds of medications where a prescriber may want to watch levels more closely, and that decision belongs to them.

Surgery, Anesthesia and Sedation

Section 5.10 of the Ozempic label addresses pulmonary aspiration during general anesthesia or deep sedation. It notes that Ozempic delays gastric emptying and that there have been rare postmarketing reports of pulmonary aspiration in patients receiving GLP-1 receptor agonists undergoing elective surgeries or procedures requiring general anesthesia or deep sedation. The label advises patients to inform healthcare providers prior to any planned surgery or procedure that they are taking Ozempic.

This is not a drug interaction in the classical sense, but it is the situation most likely to be missed. Surgical and dental teams, anesthesiologists and endoscopy units often work from a medication list assembled elsewhere. Stating a GLP-1 receptor agonist explicitly during pre-procedure screening is one of the highest-value things a patient can do.

Conditions the Label Flags That Involve Other Care

The full warnings and precautions list for Ozempic runs from risk of thyroid C-cell tumors through acute pancreatitis, diabetic retinopathy complications, the instruction never to share a pen between patients, hypoglycemia with concomitant insulin or secretagogues, acute kidney injury due to volume depletion, severe gastrointestinal adverse reactions, hypersensitivity reactions, acute gallbladder disease, and pulmonary aspiration.

Several of those intersect with other treatment. Acute kidney injury is attributed in the label to volume depletion arising from gastrointestinal adverse reactions, which is relevant to anyone whose other care depends on stable kidney function. Diabetic retinopathy complications matter to people already under ophthalmologic follow-up. These are reasons to keep the prescriber informed rather than reasons to stop treatment independently.

Why This Question Belongs to Your Pharmacist

Pharmacists run every prescription against a complete interaction database and see the full dispensing record, including medications from prescribers who are not talking to each other. That is a capability no article has. A pharmacist can also answer the question that actually matters in daily life, which is about sequence and timing rather than compatibility.

The genuinely useful preparation is a written list of everything taken, the reason for each item, and any change in how medications have felt since starting a GLP-1 receptor agonist. Handed to a prescriber or pharmacist, that list produces a better answer than any general guidance can.

Frequently Asked Questions

What medications interact with Ozempic?

The prescribing information names two categories. Insulin and insulin secretagogues such as sulfonylureas increase the risk of hypoglycemia, including severe hypoglycemia, when combined with semaglutide, and the label notes that reducing the dose of those medications may be considered when therapy is initiated. Separately, Ozempic delays gastric emptying and therefore has the potential to affect the absorption of oral medications taken at the same time.

Can I take Ozempic with metformin?

Metformin is not listed as an interaction in the Ozempic drug interactions section, and combination therapy in type 2 diabetes is common. That is not the same as clearance for an individual, because the decision depends on kidney function, other medications and the overall treatment plan. The prescriber writing the prescription should have the complete list of what you take, and your pharmacist can screen it against a full interaction database.

Do I need to tell my surgeon or dentist I take Ozempic?

Yes. The label's warnings section addresses pulmonary aspiration during general anesthesia or deep sedation, noting that semaglutide delays gastric emptying and that there have been rare postmarketing reports of aspiration in patients on GLP-1 receptor agonists undergoing elective procedures. The label specifically advises informing healthcare providers before any planned surgery or procedure. Pre-procedure screening is the moment this is most often missed.

Does Ozempic affect thyroid medication?

A drug interaction study reported in the semaglutide labeling found total thyroxine exposure increased by 33% when levothyroxine was given with the semaglutide tablet. That finding comes from the oral formulation and should not be assumed to apply identically to the injection. It illustrates the general principle that semaglutide labeling advises considering increased clinical or laboratory monitoring for oral medications with a narrow therapeutic index.

Should I stop other medications when starting Ozempic?

No, not on your own. Any change to insulin, a sulfonylurea or any other prescription is a clinical decision made by the prescriber who manages that medication. The label describes considering a dose reduction of concomitant insulin or insulin secretagogues at initiation, but that instruction is directed at the prescriber. Stopping or adjusting medications without supervision can cause harm in either direction.

How Your Genetics Relate to GLP-1 Pathways

Not everyone responds to GLP-1 medications the same way. Genetic variants — including GIPR rs1800437, FTO rs9939609, and MC4R rs17782313 — relate to the biological pathways these medications act on. These are pathway-level associations only and do not predict how much weight you will lose or how you will respond to any specific medication. PlexusDx maps 14 pathways, 49 peptides, and 150+ genetic insights so you and your provider can see how your genes relate to these pathways. It does not recommend, prescribe, or determine which medication, dose, or peptide is right for you. The PlexusDx Precision Peptide Genetic Test ($298) gives you and your provider pathway-level genetic context to support a more personalized conversation. Genetics is a guide, not a guarantee.

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Medical and Editorial Standards

Medical review process: This article was reviewed for medical accuracy, scientific clarity, evidence alignment, and appropriate discussion of genetics, medications, supplements, biomarkers, and health-related claims.

Sources and evidence: PlexusDx educational content is developed using peer-reviewed research, clinical literature, reputable medical references, and, where applicable, public health or regulatory guidance.

Commercial transparency: PlexusDx offers genetic testing, blood biomarker testing, personalized supplement recommendations, and related precision wellness services. Product mentions are intended to help readers understand available options and should not be interpreted as medical advice.

Important disclaimer: PlexusDx educational content is for informational purposes only and should not be used as a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before making decisions about medications, supplements, genetic testing, lab testing, or health-related care.