Meta Information
ID:semaglutide
Name:
Schema Version:AIM-2.0
Interactions
Target id:
/condition/history-of-mtc-or-men2
Target name:
Personal or Family History of Medullary Thyroid Carcinoma (MTC) or MEN 2
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
Semaglutide caused thyroid C-cell tumors in animal studies. It is strictly contraindicated in individuals with a personal or family history of these specific thyroid cancers.
Actionable advice:
Do not take this medication if you or a family member has a history of MTC or MEN 2.
Target id:
/class/antidiabetic-medications
Target name:
Other Diabetes Medications (especially Insulin and Sulfonylureas)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
Combining semaglutide with other glucose-lowering drugs, particularly insulin or sulfonylureas, significantly increases the risk of severe hypoglycemia (low blood sugar).
Actionable advice:
Your doctor must adjust the dose of your other diabetes medications when starting semaglutide to prevent low blood sugar.
Target id:
/procedure/general-anesthesia
Target name:
Surgery with General Anesthesia
Severity:
major
Interaction type:
adverse
Nature:
temporal
Temporal spacing:
Hours before target:
168
Hours after target:
null
Description:
Semaglutide's delay of gastric emptying significantly increases the risk of pulmonary aspiration of stomach contents during general anesthesia and deep sedation.
Actionable advice:
Inform your surgeon you are taking semaglutide; it must be held for at least one week before elective surgery.
Target id:
/dietary/alcohol-acute
Target name:
Alcohol
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
Alcohol can independently lower blood sugar, increasing the risk of hypoglycemia when taken with semaglutide. It can also irritate the pancreas, potentially increasing the risk of pancreatitis.
Actionable advice:
Limit or avoid alcohol consumption; never drink on an empty stomach while using this medication.
Target id:
/condition/pregnancy
Target name:
Pregnancy
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
Based on animal studies, there may be potential risks to the fetus. It is recommended to discontinue semaglutide at least 2 months before a planned pregnancy.
Actionable advice:
Avoid using during pregnancy and discontinue at least 2 months before attempting to conceive.
Target id:
/condition/history-of-pancreatitis
Target name:
History of Pancreatitis
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
GLP-1 receptor agonists, including semaglutide, have been associated with an increased risk of acute pancreatitis. Use is cautioned in patients with a prior history.
Actionable advice:
Inform your doctor of any history of pancreatitis before starting; report any severe abdominal pain immediately.
Target id:
/condition/severe-gastroparesis
Target name:
Severe Gastroparesis
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
Semaglutide's primary mechanism is to delay gastric emptying. In individuals who already have this condition (gastroparesis), it can cause a severe worsening of symptoms.
Actionable advice:
This medication is generally contraindicated for individuals with pre-existing severe gastroparesis.
Target id:
/dietary/meal
Target name:
Any Food, Beverage, or Other Oral Medication (for Oral Semaglutide)
Severity:
major
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
0.5
Hours after target:
null
Description:
For the oral formulation (Rybelsus), absorption is drastically reduced by food, beverages, or other medications. This interaction does not apply to the injectable form.
Actionable advice:
If taking oral semaglutide, you must wait at least 30 minutes after your dose before eating, drinking, or taking other oral pills.
Target id:
/class/oral-medications-general
Target name:
All Orally Administered Medications
Severity:
moderate
Interaction type:
diminishing
Nature:
absolute
Description:
Semaglutide significantly slows stomach emptying, which can delay and potentially reduce the absorption of any medication taken by mouth.
Actionable advice:
Discuss the timing of all oral medications with your doctor, especially those with a narrow therapeutic window like warfarin or levothyroxine.
Target id:
/condition/renal-impairment
Target name:
Renal Impairment
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Description:
Gastrointestinal side effects can lead to dehydration, which can cause or worsen kidney problems. Caution is advised in patients with pre-existing renal impairment.
Actionable advice:
Ensure adequate hydration and report any decrease in urination to your doctor; regular kidney function monitoring is advised.
Target id:
/condition/diabetic-retinopathy
Target name:
Diabetic Retinopathy
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Description:
Rapid improvement in glucose control has been associated with a temporary worsening of diabetic retinopathy. This has been observed in trials with semaglutide.
Actionable advice:
If you have a history of diabetic retinopathy, ensure regular eye exams after starting this medication.
Target id:
/dietary/high-fat-meal
Target name:
High-Fat or Greasy Meals
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Description:
High-fat foods naturally slow stomach emptying. Consuming them while on semaglutide can significantly worsen side effects like nausea, bloating, and abdominal discomfort.
Actionable advice:
Avoid large, high-fat, or greasy meals to minimize gastrointestinal side effects.
Target id:
/class/estrogens
Target name:
Oral Contraceptives
Severity:
moderate
Interaction type:
diminishing
Nature:
absolute
Description:
Semaglutide's delay of stomach emptying may reduce the absorption and effectiveness of oral hormonal contraceptives.
Actionable advice:
Consider using a non-oral or barrier method of contraception while on semaglutide, or discuss options with your doctor.
Target id:
/intervention/levothyroxine_systemic_disease
Target name:
Levothyroxine
Severity:
moderate
Interaction type:
diminishing
Nature:
absolute
Description:
Delayed gastric emptying caused by semaglutide can alter the absorption of levothyroxine, potentially affecting thyroid hormone levels.
Actionable advice:
Monitor thyroid function tests (TSH) regularly after starting or changing the dose of semaglutide.
Target id:
/intervention/warfarin
Target name:
Warfarin
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Description:
Altered absorption due to delayed gastric emptying can affect warfarin levels, potentially changing bleeding risk. Increased monitoring of INR is recommended.
Actionable advice:
Monitor your INR more frequently when starting or adjusting your semaglutide dose.
Target id:
/condition/dehydration
Target name:
Dehydration
Severity:
moderate
Interaction type:
requirement
Nature:
absolute
Description:
Semaglutide can cause nausea, vomiting, or diarrhea, leading to fluid loss. Maintaining hydration is critical to prevent acute kidney injury.
Actionable advice:
Maintain adequate hydration by drinking plenty of fluids, especially if experiencing GI side effects.
Target id:
/condition/lactation
Target name:
Breastfeeding (Lactation)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Description:
It is not known whether semaglutide passes into human breast milk. A decision should be made whether to discontinue nursing or to discontinue the drug.
Actionable advice:
Discuss the risks and benefits with your doctor before using while breastfeeding.
Target id:
/intervention/berberine
Target name:
Berberine
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Description:
Berberine also lowers blood glucose, and taking it with semaglutide can lead to an additive effect, increasing the risk of hypoglycemia.
Actionable advice:
Monitor blood glucose closely if combining these; avoid if you are prone to low blood sugar.
Target id:
/class/viscous-fibers
Target name:
Viscous Soluble Fibers (e.g., Psyllium, Glucomannan)
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Description:
High doses of gel-forming fibers can further slow gastric transit, potentially worsening gastrointestinal side effects of semaglutide like bloating, gas, or constipation.
Actionable advice:
Introduce fiber supplements slowly and ensure adequate fluid intake to minimize potential GI discomfort.
Target id:
/biomarker/amylase-lipase
Target name:
Amylase and Lipase
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Description:
Semaglutide can cause asymptomatic increases in serum amylase and lipase. Significant elevations could be a sign of pancreatitis.
Actionable advice:
Be aware that these lab values may be elevated; report any severe abdominal pain to your doctor regardless of lab results.
Target id:
/biomarker/calcitonin
Target name:
Serum Calcitonin
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Description:
Semaglutide can cause dose-dependent and treatment-duration-dependent increases in serum calcitonin, a biomarker for Medullary Thyroid Carcinoma (MTC).
Actionable advice:
The clinical significance of small increases is unknown, but persistently high levels may warrant further evaluation.