From the Guidelines
Ozempic (semaglutide) is contraindicated in patients with a personal or family history of medullary thyroid cancer or multiple endocrine neoplasia syndrome type 2 due to increased risk of thyroid C-cell tumors, as supported by the most recent evidence from 2022 1. The contraindications for Ozempic can be summarized as follows:
- Personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) due to increased risk of thyroid C-cell tumors 1
- Previous serious allergic reaction to semaglutide or any component of Ozempic
- Pregnancy and breastfeeding, as the effects on the fetus and infants are not well established
- History of pancreatitis, as GLP-1 receptor agonists have been associated with pancreatitis 1
- Severe gastrointestinal disease, particularly gastroparesis, may be worsened by Ozempic's effect on gastric emptying
- Caution is needed in patients with diabetic retinopathy, as rapid improvement in glucose control may temporarily worsen retinopathy, and in those with severe renal impairment due to limited experience in this population 1
- Ozempic is not recommended for type 1 diabetes or diabetic ketoacidosis management as it works primarily by enhancing insulin secretion from functioning pancreatic beta cells. It is essential to consider these contraindications and precautions when prescribing Ozempic to ensure the best possible outcomes for patients in terms of morbidity, mortality, and quality of life.
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 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, 2, 2
From the Research
Contraindications for Ozempic (Semaglutide)
- Personal or family history of medullary thyroid carcinoma 3, 4
- Multiple endocrine neoplasia syndrome type 2 3, 4
- History of pancreatitis, as semaglutide is not recommended in patients with suspected/confirmed pancreatitis 3
- Type 1 diabetes, as semaglutide is not indicated for this condition 3
- Pregnancy, as semaglutide is contraindicated in pregnant women 4
Special Considerations
- Patients with a history of gastrointestinal disease or at risk of gastrointestinal adverse events should be monitored closely 3, 5
- Patients at risk for deterioration of existing diabetic retinopathy should be carefully monitored if treated with semaglutide, particularly if also treated with insulin 5
- Semaglutide may increase the risk of biliary disease (cholelithiasis) and acute kidney injury 4, 5
- Patients should be aware of the potential impact of semaglutide on concomitant medications and follow administration instructions carefully to minimize adverse events 3