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Drug Interactions between chromic chloride hexahydrate and Ozempic

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

chromic chloride hexahydrate semaglutide

Applies to: chromic chloride hexahydrate and Ozempic (semaglutide)

MONITOR: Pharmacologic dosages of chromium (200 mcg/day or more for adults) may help improve diabetic control and reduce the requirements for insulin and other antidiabetic agents. Chromium appears to play a role in normal insulin function and glucose utilization, and some investigators have suggested that it increases insulin sensitivity and glucose tolerance and decreases blood glucose levels in certain diabetics, possibly those with low chromium levels. However, others have not corroborated these findings, and a few have even reported a negative effect on glucose tolerance and blood levels.

MANAGEMENT: Until further data are available, therapy with pharmacologic dosages of chromium should be administered cautiously in patients receiving insulin or other antidiabetic agents. Patients should be monitored for changes in diabetic medication requirements.

References (9)
  1. Bratman S, Kroll D. (2000) "The Natural Health Bible: From the Most Trusted Alternative Health Site in the World--Your A-Z Guide to over 300 Conditions, Herbs, Vitamins, and Supplements." Roseville, CA: Prima Health
  2. Mertz W (1998) "Interaction of chromium with insulin: a progress report." Nutr Rev, 56, p. 174-7
  3. Fox GN, Sabovic Z (1998) "Chromium picolinate supplementation for diabetes mellitus." J Fam Pract, 46, p. 83-6
  4. Anderson RA (1998) "Chromium, glucose intolerance and diabetes." J Am Coll Nutr, 17, p. 548-55
  5. Anderson RA, cheng N, Bryden NA, et al. (1997) "Elevated intakes of supplemental chromium improve glucose and insulin variables in individuals with type 2 diabetes." Diabetes, 46, p. 1786-91
  6. Abraham AS, Brooks BA, Eylath U (1992) "The effects of chromiium supplementation on serum glucose and lipids in patients with and without non-insulin-dependent diabetes." Metabolism, 41, p. 768-71
  7. Althuis MD, Jordan NE, Ludington EA, Wittes JT (2002) "Glucose and insulin responses to dietary chromium supplements: a meta-analysis." Am J Clin Nutr, 76, p. 148-55
  8. Gunton JE, Cheung NW, Hitchman R, et al. (2005) "Chromium supplementation does not improve glucose tolerance, insulin sensitivity, or lipid profile: a randomized, placebo-controlled, double-blind trial of supplementation in subjects with impaired glucose tolerance." Diabetes Care, 28, p. 712-3
  9. Martin J, Wang ZQ, Zhang XH, et al. (2006) "Chromium picolinate supplementation attenuates body weight gain and increases insulin sensitivity in subjects with type 2 diabetes." Diabetes Care, 29, p. 1826-32

Drug and food interactions

Moderate

semaglutide food

Applies to: Ozempic (semaglutide)

ADJUST DOSING INTERVAL: Taking oral semaglutide with food, beverage, or other oral medications may alter semaglutide absorption and exposure. In a controlled study with healthy volunteers, limited or no measurable semaglutide exposure was observed in subjects that were fed 30 minutes prior to taking oral semaglutide, while all subjects that fasted overnight and 30 minutes after the oral semaglutide dose had measurable semaglutide exposure. Area under the curve (AUC) and semaglutide peak plasma concentration (Cmax) were approximately 40% greater in subjects that fasted compared to those who did not. AUC and Cmax were also increased with a post-dose fasting period greater than 30 minutes.

MANAGEMENT: It is recommended that oral semaglutide be taken 30 minutes before the first food, beverage, or other oral medications of the day with no more than 4 ounces of plain water to ensure its efficacy. Fasting longer than 30 minutes after the oral semaglutide dose may lead to increased gastrointestinal side effects including nausea, vomiting, or diarrhea.

References (4)
  1. (2024) "Product Information. Rybelsus (semaglutide)." Novo Nordisk Pharmaceuticals Inc
  2. (2024) "Product Information. Rybelsus (semaglutide)." Novo Nordisk Canada Inc
  3. (2024) "Product Information. Rybelsus (semaglutide)." Novo Nordisk Ltd
  4. Baekdal TA, Breitschaft A, Donsmark M, Maarbjerg SJ, Sondergaard FL, Borregaard J (2021) "Effect of various dosing conditions on the pharmacokinetics of oral semaglutide, a human glucagon-like peptide-1 analogue in a tablet formulation" Diabetes Ther, 12, p. 1915-27

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

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