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Drug Interactions between semaglutide and thyrotropin alpha

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

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Interactions between your drugs

Moderate

thyrotropin alfa semaglutide

Applies to: thyrotropin alpha and semaglutide

MONITOR: The efficacy of semaglutide may be diminished by thyroid hormones. These drugs may interfere with blood glucose control. Additionally, concomitant administration of oral levothyroxine and semaglutide may result in increased levothyroxine exposure. In a controlled study with healthy volunteers, a 33% increase in total T4 exposure was observed when levothyroxine and oral semaglutide were coadministered, but levothyroxine peak plasma concentration (Cmax) was unaffected. The proposed mechanism is due to delayed gastric emptying caused by semaglutide leading to increased levothyroxine absorption. Clinical data with semaglutide and other thyroid hormones are unavailable.

MANAGEMENT: Caution is advised when drugs that can interfere with glucose metabolism are prescribed to patients with diabetes. Close clinical monitoring of glycemic control is recommended following initiation or discontinuation of thyroid hormones, and the dosage of semaglutide adjusted as necessary. Increased clinical monitoring of thyroid parameters should also be considered when treating patients with both semaglutide and oral levothyroxine. Administer other oral medications, including thyroid hormones at least 30 minutes after oral semaglutide to ensure medication efficacy.

References (12)
  1. (2023) "Product Information. Ozempic (semaglutide)." Novo Nordisk Pharmaceuticals Inc
  2. (2024) "Product Information. Rybelsus (semaglutide)." Novo Nordisk Pharmaceuticals Inc
  3. (2024) "Product Information. Wegovy (0.25 mg dose) (semaglutide)." Novo Nordisk Pharmaceuticals Inc
  4. (2024) "Product Information. Ozempic (semaglutide)." Novo Nordisk Canada Inc
  5. (2024) "Product Information. Rybelsus (semaglutide)." Novo Nordisk Canada Inc
  6. (2024) "Product Information. Wegovy (semaglutide)." Novo Nordisk Canada Inc
  7. (2024) "Product Information. Ozempic (semaglutide)." Novo Nordisk Ltd
  8. (2024) "Product Information. Rybelsus (semaglutide)." Novo Nordisk Ltd
  9. (2024) "Product Information. Wegovy FlexTouch (semaglutide)." Novo Nordisk Ltd
  10. (2024) "Product Information. Ozempic (1 mg dose) (semaglutide)." Novo Nordisk Pharmaceuticals Pty Ltd
  11. (2024) "Product Information. Wegovy Flextouch (0.25 mg dose) (semaglutide)." Novo Nordisk Pharmaceuticals Pty Ltd
  12. Hauge C, Breitschaft A, Hartoft-Nielsen ML, Jensen S, Baekdal TA (2021) "Effect of oral semaglutide on the pharmacokinetics of thyroxine after dosing of levothyroxine and the influence of co-administered tablets on the pharmacokinetics of oral semaglutide in healthy subjects: an open-label, one-sequence crossover, single-cente" Expert Opin Drug Metab Toxicol, 17, p. 1139-48

Drug and food interactions

Moderate

semaglutide food

Applies to: 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

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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