From the Guidelines
Ozempic (semaglutide) is contraindicated in patients with a personal or family history of medullary thyroid carcinoma (MTC) or in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). The medication should not be used in individuals with a history of serious hypersensitivity reactions to semaglutide or any of the product components. Patients with a history of pancreatitis should use Ozempic with caution, as it may exacerbate the condition 1. The medication is not recommended during pregnancy or breastfeeding due to insufficient safety data. Caution is advised in patients with diabetic retinopathy, as rapid improvement in glucose control may temporarily worsen retinopathy. Ozempic should be used carefully in patients with severe gastrointestinal disease, including gastroparesis, as it delays gastric emptying.
Some key points to consider when prescribing Ozempic include:
- Contraindications: personal or family history of MTC or MEN 2, history of serious hypersensitivity reactions to semaglutide or any of the product components 1
- Cautions: history of pancreatitis, pregnancy or breastfeeding, diabetic retinopathy, severe gastrointestinal disease, including gastroparesis 1
- Monitoring: patients with severe renal impairment should be monitored closely when using Ozempic as they may experience more gastrointestinal side effects 1
- Indications: Ozempic is indicated for the treatment of type 2 diabetes and for chronic weight management in adults with obesity 1
It is essential to weigh the benefits and risks of Ozempic in each patient, considering their individual medical history and current health status, to ensure the best possible outcome in terms of morbidity, mortality, and quality of life 1.
From the FDA Drug Label
OZEMPIC is contraindicated in patients with: • A personal or family history of medullary thyroid carcinoma (MTC) or in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) [see Warnings and Precautions (5.1)]. • Known hypersensitivity to semaglutide or to any of the product components [see Warnings and Precautions (5.7)].
The contraindications for Ozempic (semaglutide) are:
- Personal or family history of medullary thyroid carcinoma (MTC) or patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
- Known hypersensitivity to semaglutide or to any of the product components. 2
From the Research
Ozempic Contraindications
The following are contraindications for Ozempic (semaglutide):
- Personal or family history of medullary thyroid carcinoma 3
- Multiple endocrine neoplasia syndrome type 2 3
- History of pancreatitis, as semaglutide has not been studied in these patients and is not recommended for those with suspected or confirmed pancreatitis 3
- Type 1 diabetes, as semaglutide is not indicated for this condition 3
Special Considerations
When initiating Ozempic, the following should be considered:
- Gradual dose escalation is recommended to minimize the risk of gastrointestinal adverse events 3
- Patients should swallow the tablet with up to 4 fl oz/120 mL of water on an empty stomach upon waking, and wait at least 30 minutes before eating, drinking, or taking other oral medications 3
- The potential impact of these dosing conditions on concomitant medications should be considered 3
Safety Profile
The safety profile of semaglutide has been evaluated in several studies, including:
- A systematic review and meta-analysis that found no increased risk of pancreatic or thyroid cancer with semaglutide use 4
- A study that found semaglutide reduced the risk of major kidney disease events and death from cardiovascular causes in patients with type 2 diabetes and chronic kidney disease 5
- A study that found semaglutide had a similar safety profile to other GLP-1RAs, with mostly mild-to-moderate and transient gastrointestinal disturbances 6