Can Ozempic (semaglutide) be taken with gliclazide?

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Last updated: June 5, 2025View editorial policy

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From the Guidelines

Ozempic (semaglutide) can be taken with gliclazide, but careful monitoring and possible dose adjustments are necessary due to the increased risk of hypoglycemia. When these medications are used together, there is an increased risk of hypoglycemia (low blood sugar) since both medications work to lower blood glucose levels through different mechanisms. Gliclazide stimulates insulin release from the pancreas, while Ozempic slows gastric emptying, promotes insulin secretion in response to high blood sugar, and reduces glucagon production. According to the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) consensus report 1, GLP-1 receptor agonists, such as semaglutide, have minimal risk for hypoglycemia, but may increase the hypoglycemic potential of insulin and sulfonylureas when combined with those medications. Some key points to consider when taking Ozempic with gliclazide include:

  • Monitoring blood glucose levels more frequently when beginning this combination therapy or when dosages change
  • Watching for signs of hypoglycemia such as shakiness, sweating, confusion, or dizziness
  • Keeping fast-acting carbohydrates available to treat low blood sugar episodes
  • Regular follow-up appointments with your healthcare provider to ensure this medication combination is working effectively and safely for your specific situation.

From the FDA Drug Label

The risk of hypoglycemia is increased when OZEMPIC is used in combination with insulin secretagogues (e.g., sulfonylureas) or insulin. The risk of hypoglycemia may be lowered by a reduction in the dose of sulfonylurea (or other concomitantly administered insulin secretagogues) or insulin [see Warnings and Precautions (5.5)].

Ozempic (semaglutide) can be taken with gliclazide, which is a sulfonylurea, but caution is advised due to the increased risk of hypoglycemia. To minimize this risk, a reduction in the dose of gliclazide may be necessary 2.

From the Research

Ozempic and Gliclazide Combination

  • There are no direct studies on the combination of Ozempic (semaglutide) and gliclazide in the provided evidence.
  • However, the studies provide information on the efficacy and safety of gliclazide as a treatment for type 2 diabetes mellitus (T2DM) 3, 4, 5, 6, 7.
  • Gliclazide has been shown to be effective in reducing HbA1c levels and has a low risk of hypoglycemic episodes compared to other sulfonylureas 4, 5, 7.
  • The combination of gliclazide with other antihyperglycemic agents, such as metformin, has been shown to be effective in reducing HbA1c levels and improving cardiovascular risk factors 3, 6.

Potential Interactions

  • There is no direct evidence on the potential interactions between Ozempic and gliclazide.
  • However, it is known that Ozempic is a glucagon-like peptide-1 (GLP-1) receptor agonist, which can enhance glucose-dependent insulin secretion and decrease glucagon secretion 4.
  • Gliclazide, on the other hand, is a sulfonylurea that stimulates insulin secretion from the pancreas 4.
  • The combination of these two medications may enhance the risk of hypoglycemia, although gliclazide has been shown to have a lower risk of hypoglycemia compared to other sulfonylureas 5, 7.

Clinical Considerations

  • The decision to combine Ozempic and gliclazide should be made on a case-by-case basis, taking into account the individual patient's clinical characteristics, medical history, and current medications.
  • Close monitoring of blood glucose levels and potential hypoglycemic episodes is recommended when combining these two medications.
  • Further studies are needed to fully understand the efficacy and safety of the combination of Ozempic and gliclazide in patients with T2DM.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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