Drug facts
Semaglutide and other medicines
Quick answer
Two things are in the label. Combined with insulin or a sulfonylurea the risk of hypoglycemia rises, and the label says to consider reducing the dose of those. And because semaglutide delays gastric emptying, oral medicines with a narrow therapeutic index warrant closer monitoring.
Insulin and sulfonylureas1
Semaglutide lowers blood glucose, so adding it to a drug that also lowers blood glucose compounds the effect. The label says the risk of hypoglycemia is increased with insulin or insulin secretagogues, and that when starting semaglutide a prescriber should consider reducing the dose of the other drug.
It also notes something easy to miss: adding semaglutide to insulin has not been evaluated. That is not the same as being ruled out, and it is not the same as being studied and found safe.
Metformin is not named in section 7.1. How the labels treat semaglutide and metformin together, including the trials that ran on a metformin background, is on the metformin page.
Oral medicines2
The concern is mechanical rather than chemical: a stomach that empties more slowly can change how fast an oral drug is absorbed. The label asks for increased clinical or laboratory monitoring for oral medicines with a narrow therapeutic index, or that require monitoring anyway.
The measured findings are more specific than the warning suggests. In clinical pharmacology trials, semaglutide 1 mg once-weekly injection did not affect the absorption of orally administered medications. The one quantified interaction is with the semaglutide tablet, where levothyroxine exposure rose 33%.
What is not in this label2
There is no oral-contraceptive instruction. This is worth stating because the equivalent tirzepatide label does carry one — telling patients to switch to a non-oral method or add a barrier for four weeks after starting and after each dose increase. Someone who has read about one drug and is taking the other can easily carry that instruction across, and it does not appear here.
An absence in a label is not a guarantee of safety. It means this document does not address it, and that is a question for a prescriber rather than a page.
What this page is not
This is not a complete interaction check. It reports what sections 7.1 and 7.2 of the approved label say; a pharmacist with your full medicine list is the right check, and a compounded vial does not change any of it — see side effects.