How To Avoid Medication Interaction Problems When Dieting With Ozempic

All the new injectable GLP-1 (glucagon-like peptide-1) receptor agonists are very effective and well tolerated medications. We at Women’s Health Practice have supervised their use for many years. They are potent medications that may potentially have interactions with the medicines you are on.

GLP-1 enhance insulin secretion, inhibiting glucagon release, slowing gastric emptying, and promoting feeling full or what is known as satiety. While generally safe and effective, GLP-1 receptor agonists can interact with other medications. Here are some key drug interactions to be aware of:

1. Oral Medications:

  • Delayed Absorption: GLP-1 receptor agonists slow gastric emptying, which can delay the absorption of oral medications. This can affect the timing and effectiveness of drugs like oral contraceptives, antibiotics, and other medications that require consistent absorption.
  • Monitoring Required: For critical medications (e.g., warfarin, digoxin), monitoring blood levels and adjusting dosages may be necessary.

2. Hypoglycemic Agents:

  • Sulfonylureas and Insulin: Combining GLP-1 receptor agonists with sulfonylureas or insulin can increase the risk of hypoglycemia (low blood sugar). Dosage adjustments of the sulfonylurea or insulin may be required to mitigate this risk.

3. Other Antidiabetic Medications:

  • Metformin: Generally, no significant interactions, and they are often used together effectively.
  • DPP-4 Inhibitors: Concurrent use with DPP-4 inhibitors (e.g., sitagliptin) is usually not recommended, as both affect the GLP-1 pathway and do not provide additional benefit.

4. Gastrointestinal Medications:

  • Proton Pump Inhibitors (PPIs) and H2 Antagonists: No significant interactions, but monitoring for altered drug absorption due to changes in gastric pH and motility is prudent.

5. Other Considerations:

  • Contraceptives: For oral contraceptives, take them at least 1 hour before or 11 hours after the GLP-1 receptor agonist to avoid reduced effectiveness due to delayed gastric emptying. This is only for those on the oral version, and has very little relevance to those on the injectables Zepbound and Wegovy.
  • Thyroid Medications: No significant interactions, but thyroid function should be monitored as GLP-1 receptor agonists can affect thyroid hormone levels in some patients.
  • Antibiotics: Adjustments in timing may be necessary due to delayed absorption; take antibiotics at least 1 hour before or 4 hours after the GLP-1 receptor agonist.

 

6. Herbal Supplements:

  • St. John’s Wort and Others: Herbal supplements can affect drug metabolism, and caution should be exercised. Consult a healthcare provider before combining them with GLP-1 receptor agonists.

 

Key Points for Patients:

  • Consistent Timing: Take other oral medications at a time when the GLP-1 receptor agonist is least likely to affect their absorption.
  • Monitor Blood Sugar Levels: Especially when starting or adjusting doses, monitor blood sugar levels closely to avoid hypoglycemia.
  • Consult Healthcare Providers: Always inform healthcare providers about all medications and supplements being taken to manage potential interactions effectively.

Regular follow-up with us as your healthcare provider is essential to monitor for drug interactions and adjust treatment plans as needed.