Semaglutide tablets stimulate insulin release in the setting of elevated blood glucose concentrations. The risk of hypoglycemia (including severe hypoglycemia) may be increased in patients receiving semaglutide tablets in combination with an insulin secretagogue (e.g., sulfonylureas) or insulin.
When initiating semaglutide tablets, consider reducing the dose of concomitantly administered insulin secretagogue (e.g., sulfonylureas) or insulin to lower the risk of hypoglycemia.
Semaglutide tablets delay gastric emptying and therefore have the potential to affect the absorption of other oral medications. In a drug-drug interaction study, levothyroxine exposure was increased by 33% when levothyroxine was administered concomitantly with semaglutide tablets.
Consider increasing clinical or laboratory monitoring when semaglutide tablets are used concomitantly with other oral medications that have a narrow therapeutic index or require clinical monitoring.
FDA,2025.10