Who Should Not Take Semaglutide: What You Need to Know

You have definitely heard of semaglutide — a game-changing medication created for people with type 2 diabetes and those trying to lose weight. You might know it by the brand names Ozempic or Wegovy, and it’s typically given as a once-a-week injection.

However, while semaglutide injection does magic, helping control high blood sugar (glucose) and reduce appetite, it’s not a “magic pill” for everyone. Some people should not use semaglutide because it could lead to serious health problems.

In this post, we’ll explore who should not take semaglutide, what the side effects might be, and why it’s important to be cautious before starting this treatment.

What Is Semaglutide?

Semaglutide is a GLP-1 receptor agonist medication. It is supplied in different dosage forms depending on the indication it’s used for.

For example, Ozempic is available in the following dosage forms: 0.25 mg, 0.5 mg, 1 mg and 2 mg. It is usually prescribed for blood sugar control in people with type 2 diabetes.

Wegovy has slightly different doses: 0.25 mg, 0.5 mg, 1.7 mg and 2.4 mg, and is used for weight management. Semaglutide makes your body produce more insulin and slows down digestion. It can make you feel fuller longer, so you’re less likely to overeat. All of that leads to losing weight.

Another form of semaglutide is compounded semaglutide. It is a custom-made version produced by compounding pharmacies and is not FDA-approved. Compounded semaglutide allows patients to customize their dosage. It is also often less expensive than its branded counterparts.

Semaglutide is an injectable medication injected once a week in one of the following injection sites: upper arm, thigh, or stomach area.

However, even though it sounds like a miracle drug, semaglutide isn’t for everyone. There are certain medical conditions and risk factors that could make this drug dangerous.

Who Should Avoid Semaglutide?

Semaglutide is a safe medication for most people if used correctly. However, some groups of patients should consider not using it.

People With History of Thyroid Cancer

Semaglutide may potentially increase the risk of thyroid tumors, as studies show. If you or anyone in your family has had medullary thyroid carcinoma or Multiple Endocrine Neoplasia Syndrome Type 2 (MEN 2), you should not take semaglutide.

For that reason, semaglutide drugs bear a “black box warning.” It means that if you notice any symptoms like trouble swallowing or a lump in your neck, you should contact your doctor immediately.

However, there is a new study conducted in 2023 by the European Medicines Agency’s (EMA) Pharmacovigilance Risk Assessment Committee that showed no association between GLP-1 receptor agonist drugs like semaglutide and cancer of the thyroid.

Severe Gastrointestinal Disease

If you have severe stomach or intestinal problems like gastroparesis, semaglutide can make these conditions worse. The drug slows down your digestion, which can lead to severe stomach pain, nausea, or even vomiting. For people with severe gastrointestinal diseases, these side effects can be extremely hard to handle.

Diabetic Ketoacidosis (DKA)

Semaglutide is prescribed to people with type 2 diabetes, but if you have type 1 diabetes or have ever experienced diabetic ketoacidosis (DKA), you may not want to use it.

DKA is a serious condition caused by very high blood glucose levels, and semaglutide won’t lower your sugar fast enough to help in that situation. People who have had DKA need faster, more effective treatments.

Kidney Problems

If you have kidney disease or have had a recent heart attack, semaglutide can make things worse. The drug can sometimes cause dehydration, which can be harmful to your kidneys. If you have kidney issues, your healthcare provider may recommend other medications that don’t increase this risk.

Diabetic Retinopathy

If you have diabetic retinopathy you might want to be cautious when using semaglutide. Some earlier research showed that semaglutide could worsen this condition in people with diabetes.

However, recent research shows that semaglutide does not increase the chance of diabetic eye disease.

Pregnant and Breastfeeding Women

Semaglutide is not recommended for pregnant women and breastfeeding mothers, as there is no data on whether semaglutide passes to breast milk.

What Are the Potential Risks?

Low Blood Sugar (Hypoglycemia)

Semaglutide can lead to low blood sugar (also known as hypoglycemia), especially if you’re taking other diabetes medications. If your blood glucose drops too low, you could feel symptoms of low blood glucose, like being dizzy, shaky, or confused. In some cases, you might need to take glucose tablets or eat something sweet to bring your sugar levels back to a safe level.

So it is not recommended to take other medicines while you are using semaglutide unless they have been discussed with your healthcare provider.

Allergic Reactions

Like any medication, semaglutide can cause unusual or allergic reaction in some people.

If you experience symptoms like trouble breathing, swelling, or a rash after taking semaglutide, you need to seek medical attention immediately.

Interactions and Lifestyle Considerations

Drug Interactions

Semaglutide can interact with other medications, including both prescription drugs and over-the-counter medications. But some interactions may lead to dangerously low blood glucose levels or increase the risk of other side effects. This is why it’s important to inform your healthcare provider about the other medicines you’re currently taking.

Alcohol Use

Drinking alcohol while on semaglutide can affect blood sugar levels in unpredictable ways. It can either raise or lower your blood glucose.

Acohol also adds extra calories to your daily intake, which can make it harder to stick to your diet plan. So you may not want to drink alcohol while on semaglutide.

Missed Doses

If you miss a dose of semaglutide, it’s not bad so don’t worry. If it’s been less than 5 days since your missed dose, you can take the next dose as soon as you remember.

However, if more than five days have passed, just skip the missed dose and take your next one at the regular time. Never double up on doses, as this can lead to more severe side effects.

Who Can Benefit from Semaglutide?

Even though there are several groups of patients who shouldn’t take semaglutide, there are many people who can greatly benefit from it.

If you have type 2 diabetes and are struggling to control your blood sugar, semaglutide can be your solution.

Semaglutide is also a choice for overweight or obese people, as it promotes weight loss when combined with diet and exercise. It also improves cravings and appetite control, balances blood sugar, and helps prevent heart disease, blood vessel disease and high blood pressure.

The Importance of Talking to Your Doctor

Before starting semaglutide, it’s crucial to talk to your healthcare provider. Your doctor will look at your personal medical history and family medical history, check if you have conditions like thyroid cancer, kidney problems, or gastrointestinal issues, and decide if semaglutide is safe for you.

They’ll also help you figure out how semaglutide fits into your overall health plan, especially if you’re already taking other medications.

Final Thoughts

While semaglutide is very effective to lower blood sugar levels and help with weight loss, it’s not for everyone.

People with endocrine tumors, severe gastrointestinal issues, diabetic ketoacidosis, or kidney problems, as well as pregnant and breastfeeding women, should not use it. Additionally, there is an increased risk of low blood sugar, allergic reaction, and thyroid tumors that need to be considered.

Remember, semaglutide is not a quick fix. It works best when combined with lifestyle changes like healthy diet and regular physical activity.

Always talk to your doctor or healthcare provider before starting any new medication. They’ll guide you through the potential risks and benefits, helping you make the best decision for your health.