How should a patient with type 2 diabetes taking Ozempic (semaglutide) adjust their medication regimen when also taking Augmentin (amoxicillin/clavulanate)?

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No Dose Adjustment Required for Ozempic When Taking Augmentin

Ozempic (semaglutide) does not require any dosage adjustment when taken with Augmentin (amoxicillin/clavulanate), as semaglutide has minimal clinically significant drug interactions with commonly prescribed antibiotics.

Pharmacokinetic Evidence

The pharmacokinetic profile of semaglutide demonstrates no clinically relevant interactions with oral medications. Semaglutide does not affect the absorption, distribution, or elimination of concomitantly administered oral drugs to a degree requiring dose modification 1. Studies evaluating semaglutide co-administration with multiple oral medications (metformin, warfarin, atorvastatin, and digoxin) showed that area under the plasma concentration-time curve ratios remained within the pre-specified non-interaction interval of 0.80-1.25 1.

Mechanism of Low Interaction Potential

GLP-1 receptor agonists, including semaglutide, have very low drug interaction potential and are recommended as ideal combination partners from a clinical-pharmacologic perspective 2. Unlike medications that significantly affect cytochrome P450 enzymes or drug transporters, semaglutide's mechanism—enhancing glucose-dependent insulin secretion, suppressing glucagon, and delaying gastric emptying—does not interfere with antibiotic pharmacokinetics 2.

Practical Administration Guidelines

  • Continue Ozempic on its regular weekly schedule without interruption when prescribed Augmentin 1
  • Maintain the same semaglutide dose (whether 0.5 mg, 1 mg, or 2 mg weekly) throughout the antibiotic course 1
  • Take Augmentin as prescribed without timing adjustments relative to Ozempic injection 1

Monitoring Considerations

While no dose adjustment is needed, patients should be aware that:

  • Gastrointestinal side effects may be additive if both medications cause nausea or diarrhea, though this does not necessitate stopping either medication 1, 3
  • Blood glucose monitoring remains important during any acute illness requiring antibiotics, as infection itself can affect glycemic control 4
  • Most adverse events with semaglutide and co-administered medications are comparable to semaglutide alone and are predominantly gastrointestinal 1

Common Pitfall to Avoid

Do not discontinue or reduce Ozempic dose when starting Augmentin, as this would unnecessarily compromise diabetes management without providing any safety benefit 1. The combination has been shown to be safe with no new safety signals identified 1.

References

Research

Clinically and pharmacologically relevant interactions of antidiabetic drugs.

Therapeutic advances in endocrinology and metabolism, 2016

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

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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