BLACK BOX WARNING:

GLP-1s are contraindicated in individuals with a history of medullary thyroid carcinoma, a family history of such, or in patients with multiple endocrine neoplasia syndrome type 2. Do not take them if you have ever had thyroid cancer. In studies with rodents, GLP-1s caused thyroid tumors, including thyroid cancer; it is not known if they will cause thyroid tumors or cancer in humans. Please notify your doctor ASAP if you develop trouble swallowing, hoarseness, a lump or swelling in your neck, or shortness of breath. 

If you experience a medical emergency, call 911 or go to the nearest emergency room.

Tell your healthcare provider about your medical history prior to taking Wegovy®.

Avoid alcohol while taking this medication. If you’re taking diabetes medications, please discuss this with your prescribing doctor before starting Wegovy®, as your diabetes medications may need to be adjusted as you lose weight.

Use adequate contraception while taking this medication. Do not take this medication if pregnant, trying to get pregnant or breastfeeding. If you plan to become pregnant, this medication needs to be stopped at least 2 months before trying. This medication may cause fetal harm.

Notify your doctor if you have kidney, liver, or pancreas problems.

Stop using Wegovy® and call your healthcare provider immediately if you have severe stomach or abdomen pain that will not go away, with or without vomiting.

Stop using Wegovy® and get medical help right away if you have any symptoms of a serious allergic reaction, including swelling of your face, lips, tongue, or throat; problems breathing or swallowing; severe rash or itching; fainting or feeling dizzy; or very rapid heartbeat.

Serious hypersensitivity reactions (e.g., anaphylaxis and angioedema) have been reported. Discontinue Wegovy® if suspected and promptly seek medical advice.

WARNING

Please contact your doctor ASAP and seek in-person care immediately if a side effect becomes problematic or you experience:

• -Severe nausea and/or vomiting resulting in dehydration-  it is important to stay well hydrated and drink plenty of fluids while on this medication 
• -Kidney problems/kidney failure - vomiting, nausea, diarrhea can cause dehydration and kidney issues and make kidney problems worse in individuals who have pre-existing kidney conditions; may sometimes lead to the need for hemodialysis 
• -Thyroid C-Cell Tumor: Trouble swallowing, hoarseness, a lump or swelling in your neck, or shortness of breath (see black box warning below)
• -Pancreatitis: Severe pain in your abdomen or back that will not go away 
• -Acute gallbladder disease - Pain in the middle or right upper stomach, fever, white parts of your eyes turn yellow or skin turns yellow, nausea/vomiting. If gallstones or inflammation of the gallbladder is suspected further studies are needed.
• -Hepatitis/Elevated liver enzymes/Jaundice
• -Diabetic retinopathy problems: Changes in vision in those with type II diabetes, particularly vision problems may worsen in those with a history of diabetic retinopathy 
• -Severe gastrointestinal disease - may cause gastrointestinal disease; do not use if you have a history of severe gastrointestinal disease 
• -Signs of low blood sugar (for example, dizziness, weakness, shakiness, jitteriness, headache, anxiety/mood changes, rapid heartbeat, confusion, slurred speech, sweating, or lightheadedness). While this is rare with GLP-1s, if it occurs, please seek in-person care immediately. If you have these symptoms, try having liquid or food containing sugar (around 15-20 grams) —drinking juice, having regular soda, or eating some hard candies right away, as this will help raise your blood sugar quickly. If taken with insulin or an insulin secretagogue (ie sulfonylurea) it is best to talk to your healthcare provider about possibly lowering the dose of these medications to lower the risk of hypoglycemia. 
• -Increasing heart rate
• -Worsening depression, behavior changes, or suicidality
• -Never share the Wegovy® pen with other people

Side effects

Many people experience no side effects. Some of the most common or potential side effects include:

• -Nausea
• -Constipation
• -Vomiting
• -Diarrhea
• -Abdominal Pain
• -Headache
• -Indigestion 
• -Injection site reactions
• -Dizziness
• -Back pain
• -Increased Lipase or Amylase 
• -Altered taste
• -Nasopharyngitis (common cold)
• -Passing Gas
• -Bloating
• -Belching
• -Gastroenteritis
• -Decreased appetite 
• -Fatigue
• -Gastroesophageal reflux disease
• -Low blood sugar (hypoglycemia) in those with type II diabetes
• -Upset stomach

These symptoms often subside as your body adjusts to the medications. Please notify your provider if side effects persist. For a complete list of side effects, review the medication packaging inserts.

Drug interactions

As with other medications, Wegovy® can interact with alcohol and certain prescription and non-prescription medications and herbal products. The risk of hypoglycemia is increased when combined with insulin or insulin secretagogues such as sulfonylureas. Wegovy® delays gastric emptying and may impact the absorption of oral medications. If you are on thyroid hormone medication, prior to starting Wegovy®, please review the timing of taking your thyroid hormone medication with the doctor who prescribes it as it may need to be adjusted. The drug levels of medications with narrow therapeutic windows (ie warfarin) should be monitored closely while on Wegovy®.

Please consult the pharmaceutical packaging for a full list of side effects, warnings, interactions and additional information. 

To report suspected adverse reactions to Wegovy® contact the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

In case of emergencies, please call 911 or go to the nearest emergency room.

N/A

WARNING

Acarbose can cause a severe allergic reaction. Symptoms may include:

• -skin swelling and redness
• -hives
• -itching
• -rash
• -fever
• -trouble breathing or chest tightness
• -blistering or peeling skin
• -swelling of your mouth, face, lips, tongue, or throat

Call 911 or go to the nearest emergency room if you develop these symptoms.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal.

Alcohol interaction warning

Alcohol can affect your blood sugar level. It can both increase the risk of low blood sugar (hypoglycemia) as well as increase your blood sugar levels by serving as an additional source of carbohydrates. Talk with your doctor before drinking alcohol.

Warnings for people with certain health conditions

For people with diabetic ketoacidosis: Don’t take this medication if you have diabetic ketoacidosis. Diabetic ketoacidosis is a serious condition that can result in unconsciousness and potentially death. Symptoms of this condition develop slowly. They include dry mouth or being very thirsty, high blood sugar levels, and urinating frequently. If you begin vomiting and suspect you have this condition, call your doctor or go to the hospital immediately. This condition can become life-threatening within a few hours once you’re vomiting.

For people with cirrhosis or liver disease: Don’t take acarbose if you have cirrhosis or severe liver disease. Taking acarbose could make your condition worse.

For people with intestinal disease: If you have certain intestinal diseases, such as inflammatory bowel disease, colonic ulceration, or partial intestinal obstruction, or if you’re predisposed to intestinal obstruction, you shouldn’t take acarbose. Taking it could make your condition worse.

For people who take insulin or a sulfonylurea: When acarbose is taken with these other drugs, it may increase your risk for developing low blood sugar (hypoglycemia). Signs of hypoglycemia may include fast heart rate, confusion, hunger, sweating, shaking, or feeling weak and dizzy. Use glucose tablets or liquid glucose to help manage a hypoglycemic event while taking acarbose. Cane sugar (sucrose) won’t work to treat your hypoglycemia while you’re taking acarbose. Use oral glucose (dextrose) products instead.

Warnings for other groups

For pregnant women: Acarbose is a pregnancy category B drug. That means two things:

1. Studies of the drug in pregnant animals have not shown risk to the fetus.
2. There aren’t enough studies done in pregnant women to show the drug poses a risk to the fetus.

Tell your doctor if you’re pregnant or plan to become pregnant. Acarbose should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

For women who are breastfeeding: Research on lactating rats has shown small amounts of acarbose in the rat milk. It isn’t known if acarbose passes through human breast milk. You and your doctor should decide if you’ll take acarbose or breastfeed.

For children: The safety and effectiveness of acarbose in people younger than 18 years haven’t been proved.

Side effects

Acarbose does not cause drowsiness, but it can cause other side effects.

More common side effects

The more common side effects from using acarbose include:

• -stomach pain
• -diarrhea
• -flatulence (gas)

These side effects usually develop during the first few weeks after taking acarbose. They should decrease as you continue to take the medication, typically within a few days or a couple of weeks. Talk to your doctor or pharmacist if they’re more severe or don’t go away.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

Allergic skin reaction. Symptoms may include:

• -rash
• -redness
• -swelling of your skin

Liver problems. Symptoms may include:

yellowing of the whites of your eyes or skin

stomach swelling

pain in the upper right portion of your stomach

• -Pneumatosis cystoides intestinalis. These are gas-filled cysts on the wall of your intestines. They can cause intestinal problems, such as holes, blockage, or bleeding. Symptoms may include:
• -diarrhea
• -mucus discharge
• -rectal bleeding
• -constipation

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

Drug interactions

Acarbose oral tablet can interact with other medications, herbs, or vitamins you might be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Examples of drugs that can cause interactions with acarbose are listed below.

Diabetes drugs

When you take certain other diabetes drugs with acarbose, your blood sugar level can get too low, causing hypoglycemia. Signs of hypoglycemia may include fast heart rate, confusion, hunger, sweating, shaking, or feeling weak and dizzy. Examples of these drugs include:

• -sulfonylureas, such as glyburide or glimepiride
• -insulin

Note: Use glucose tablets or liquid glucose to help manage a hypoglycemic event while you’re taking acarbose. Cane sugar (sucrose) won’t work to treat hypoglycemia while you’re taking acarbose. Use oral glucose (dextrose) products instead.

Thyroid drug

Taking levothyroxine with acarbose may affect your blood sugar level. If you take these drugs together, your doctor will adjust your diabetes medications accordingly.

Estrogens and oral contraceptives

Taking certain hormonal medications with acarbose may affect your blood sugar level. Your doctor will adjust your diabetes medications accordingly. Examples of these drugs include:

• -ethinyl estradiol/norgestimate
• -ethinyl estradiol/levonorgestrel
• -ethinyl estradiol/norethindrone
• -ethinyl estradiol/drospirenone

Diuretics (water pills)

Taking acarbose with certain drugs that cause your body to lose water may lead to your blood sugar level getting too high, resulting in hyperglycemia. Examples of these drugs include:

thiazide diuretics such as:

• -hydrochlorothiazide
• -chlorthalidone

loop diuretics such as:

-furosemide

-bumetanide

-torsemide

• -triamterene

Corticosteroids

Taking acarbose with corticosteroids may cause your blood sugar level to get too high, resulting in hyperglycemia. Examples of these drugs include:

• -hydrocortisone
• -prednisone
• -prednisolone
• -methylprednisolone

Antipsychotic drugs

Taking chlorpromazine with acarbose may cause your blood sugar level to get too high, resulting in hyperglycemia.

Seizure drugs

Taking certain seizure medications with acarbose may affect your blood sugar level. Examples of these drugs include:

• -phenytoin
• -fosphenytoin

Nicotinic acid

Taking niacin with acarbose can cause your blood sugar level to get too high, resulting in hyperglycemia.

Sympathomimetics

Taking drugs called sympathomimetics with acarbose may cause your blood sugar level to get too high, resulting in hyperglycemia. Examples of these drugs include:

• -pseudoephedrine
• -phenylephrine

Blood pressure drugs

Taking certain blood pressure drugs called beta-blockers with acarbose may cause your blood sugar level to get too high, resulting in hyperglycemia. It can also delay how long it takes for your blood sugar to return to normal. Beta-blockers can also mask some of the signs of low blood sugar, such as higher than normal heart rate, palpitations, and shakiness. Examples of these drugs include:

• -metoprolol
• -isoprolol
• -atenolol
• -nadolol
• -propranolol

Tuberculosis drug

Taking isoniazid with acarbose may cause your blood sugar level to get too high, resulting in hyperglycemia.

Heart problem drug

Taking digoxin with acarbose can cause the levels of digoxin in your body to change. If you take these drugs together, your dose of digoxin may need to be adjusted by your doctor.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

To report suspected adverse reactions to acarbose contact the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

In case of emergencies, please call 911 or go to the nearest emergency room.

BLACK BOX WARNING:

GLP-1s are contraindicated in individuals with a history of medullary thyroid carcinoma, a family history of such, or in patients with multiple endocrine neoplasia syndrome type 2. Do not take them if you have ever had thyroid cancer. In studies with rodents, GLP-1s caused thyroid tumors, including thyroid cancer; it is not known if they will cause thyroid tumors or cancer in humans. Please notify your doctor ASAP if you develop trouble swallowing, hoarseness, a lump or swelling in your neck, or shortness of breath. 

If you experience a medical emergency, call 911 or go to the nearest emergency room.

Tell your healthcare provider about your medical history prior to taking Ozempic®.

Avoid alcohol while taking this medication. If you’re taking diabetes medications, please discuss this with your prescribing doctor before starting Ozempic®, as your diabetes medications may need to be adjusted as you lose weight.

Use adequate contraception while taking this medication. Do not take this medication if pregnant, trying to get pregnant or breastfeeding. If you plan to become pregnant, this medication needs to be stopped at least 2 months before trying. This medication may cause fetal harm.

Notify your doctor if you have kidney, liver, or pancreas problems.

Stop using Ozempic® and call your healthcare provider immediately if you have severe stomach or abdomen pain that will not go away, with or without vomiting.

Stop using Ozempic® and get medical help right away if you have any symptoms of a serious allergic reaction, including swelling of your face, lips, tongue, or throat; problems breathing or swallowing; severe rash or itching; fainting or feeling dizzy; or very rapid heartbeat.

Serious hypersensitivity reactions (e.g., anaphylaxis and angioedema) have been reported. Discontinue Ozempic® if suspected and promptly seek medical advice.

WARNING

Please contact your doctor ASAP and seek in-person care immediately if a side effect becomes problematic or you experience:

• -Severe nausea and/or vomiting resulting in dehydration-  it is important to stay well hydrated and drink plenty of fluids while on this medication 
• -Kidney problems/kidney failure - vomiting, nausea, diarrhea can cause dehydration and kidney issues and make kidney problems worse in individuals who have pre-existing kidney conditions; may sometimes lead to the need for hemodialysis 
• -Thyroid C-Cell Tumor: Trouble swallowing, hoarseness, a lump or swelling in your neck, or shortness of breath (see black box warning below)
• -Pancreatitis: Severe pain in your abdomen or back that will not go away 
• -Acute gallbladder disease - Pain in the middle or right upper stomach, fever, white parts of your eyes turn yellow or skin turns yellow, nausea/vomiting. If gallstones or inflammation of the gallbladder is suspected further studies are needed.
• -Hepatitis/Elevated liver enzymes/Jaundice
• -Diabetic retinopathy problems: Changes in vision in those with type II diabetes, particularly vision problems may worsen in those with a history of diabetic retinopathy 
• -Severe gastrointestinal disease - may cause gastrointestinal disease; do not use if you have a history of severe gastrointestinal disease 
• -Signs of low blood sugar (for example, dizziness, weakness, shakiness, jitteriness, headache, anxiety/mood changes, rapid heartbeat, confusion, slurred speech, sweating, or lightheadedness). While this is rare with GLP-1s, if it occurs, please seek in-person care immediately. If you have these symptoms, try having liquid or food containing sugar (around 15-20 grams) —drinking juice, having regular soda, or eating some hard candies right away, as this will help raise your blood sugar quickly. If taken with insulin or an insulin secretagogue (ie sulfonylurea) it is best to talk to your healthcare provider about possibly lowering the dose of these medications to lower the risk of hypoglycemia. 
• -Increasing heart rate
• -Worsening depression, behavior changes, or suicidality
• -Never share the Ozempic® pen with other people

Side effects

Many people experience no side effects. Some of the most common or potential side effects include:

• -Nausea
• -Constipation
• -Vomiting
• -Diarrhea
• -Abdominal Pain
• -Headache
• -Indigestion 
• -Injection site reactions
• -Dizziness
• -Back pain
• -Increased Lipase or Amylase 
• -Altered taste
• -Nasopharyngitis (common cold)
• -Passing Gas
• -Bloating
• -Belching
• -Gastroenteritis
• -Decreased appetite 
• -Fatigue
• -Gastroesophageal reflux disease
• -Low blood sugar (hypoglycemia) in those with type II diabetes
• -Upset stomach

These symptoms often subside as your body adjusts to the medications. Please notify your provider if side effects persist. For a complete list of side effects, review the medication packaging inserts.

Drug interactions

As with other medications, Ozempic® can interact with alcohol and certain prescription and non-prescription medications and herbal products. The risk of hypoglycemia is increased when combined with insulin or insulin secretagogues such as sulfonylureas. Ozempic® delays gastric emptying and may impact the absorption of oral medications. If you are on thyroid hormone medication, prior to starting Ozempic®, please review the timing of taking your thyroid hormone medication with the doctor who prescribes it as it may need to be adjusted. The drug levels of medications with narrow therapeutic windows (ie warfarin) should be monitored closely while on Ozempic®.

Please consult the pharmaceutical packaging for a full list of side effects, warnings, interactions and additional information. 

To report suspected adverse reactions to Ozempic® contact the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

In case of emergencies, please call 911 or go to the nearest emergency room.

N/A

WARNING

DO NOT take naltrexone if you are taking ANY opioids or opiate drugs or if you are dependent on opioids or using methadone or buprenorphine, or if you are in opioid withdrawal. If you take opioids/opiates right after stopping naltrexone you may be more sensitive to them (and require lower doses) - which poses a risk of overdose. Please talk to your provider before initiating any amount of opioids/opiates after stopping naltrexone. Do not take this medication if you have a sensitivity to it or any of its components.

Before using naltrexone, tell your healthcare provider about your medical history, especially if you have:

• -kidney disease
• -liver disease (as it may cause liver dysfunction or hepatitis)
• -depression/suicidality
• -current or recent (7-14 days) use of any type of opioid or opiate drugs

This drug may make you dizzy or drowsy or impair your judgment. Please do not drive, operate heavy machinery, or perform any hazardous task until the effects of naltrexone are known to you. For anyone taking diabetes medications, please have a discussion with your prescribing clinician prior to taking naltrexone as your diabetes medications may need to be adjusted as you lose weight. You should wear medical identification stating that you are taking this drug so that appropriate treatment can be given in a medical emergency.

Tell your healthcare provider right away if you experience severe stomach or abdominal pain changes in vision, eye pain, burning or swollen eyes, chest pain, confusion, discomfort while urinating or frequent urination, fever, hallucinations or seeing, hearing, or feeling things that are not there, itching, mental depression or other mood or mental changes or suicidality, ringing or buzzing in the ears, shortness of breath, swelling of the face, feet, or lower legs or weight gain.

DO NOT take naltrexone if you are planning to become pregnant or if pregnant or breastfeeding.

Side effects

Many people experience no side effects while taking naltrexone. Some of the most common side effects (but not extremely frequent) are:

• -fatigue or low energy
• -difficulty sleeping
• -nervousness and anxiety
• -headache
• -nausea or vomiting
• -joint and muscle pain
• -stomach cramps or pain

Additional side effects include:

• -loss of appetite
• -diarrhea or constipation
• -increased energy
• -increased thirst
• -dizziness
• -skin rash
• -sexual problems in males
• -chills
• -runny nose
• -irritability or feeling down

These symptoms may subside after the body adjusts to the medication.

Drug interactions

As with other medications, naltrexone can interact with certain prescription and non-prescription medications and herbal products, including dextromethorphan, diarrhea medication, disulfiram, opioid pain or cough relievers (such as codeine) and thioridazine.
Please consult the pharmaceutical packaging for a full list of side effects, warnings, interactions and additional information.

To report suspected adverse reactions to naltrexone contact the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

In case of emergencies, please call 911 or go to the nearest emergency room.

N/A

WARNING

Do not use orlistat if you have had an organ transplant because the medicine interferes with the medicines used to prevent transplant rejection. There have been rare reports of liver injury in people taking orlistat.

Before using orlistat tell your healthcare provider about your medical history, especially if you have:

• -gallbladder problems
• -kidney stones
• -pancreatitis

Ask your healthcare provider before you use orlistat if you are taking any of the following prescription medications:

• -anticoagulants (blood thinning medicine)
• -amiodarone (heart medicine)
• -diabetes medicine
• -thyroid disease medicine
• -seizure medicine (for a seizure disorder)
• -antiretrovirals (HIV medicine)
• -taking any other weight loss products

You should not take orlistat if you are planning to become pregnant or if pregnant or breastfeeding. Do not use orlistat if you are not overweight or if you have been diagnosed with problems absorbing food. When using this medication, you should also take a multivitamin once a day at bedtime, and follow a well-balanced, reduced-calorie, low-fat diet. If you have any serious side effects, including, itching, yellow eyes or skin, dark urine, loss of appetite, severe or continuous abdominal pain, hives, vomiting, chest pain, rectal bleeding, constipation that lasts more than 7 days, difficulty swallowing or breathing, or you are taking medicine for seizures and your seizures happen more often or get worse, stop using the medication and talk to your healthcare provider

Side effects

Many people experience no side effects while taking orlistat. Some of the most common side effects (but not extremely frequent) are:

• -diarrhea
• -oily stools or spotting
• -stomach discomfort
• -gas
• -more frequent bowel movements that may be hard to control

Additional side effects include:

• -loss of appetite
• -diarrhea or constipation
• -increased energy
• -increased thirst
• -dizziness
• -skin rash
• -sexual problems in males
• -chills
• -runny nose
• -irritability or feeling down

These symptoms may subside after the body adjusts to the medication.

Drug interactions

Do not take orlistat if you are taking cyclosporine, warfarin or you are allergic to any of the ingredients in the capsules. Do not take thyroid medication or any fat-based supplements within 2 hours of taking orlistat.

Please consult the pharmaceutical packaging for a full list of side effects, warnings, interactions and additional information.

To report suspected adverse reactions to orlistat contact the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

In case of emergencies, please call 911 or go to the nearest emergency room.

N/A

WARNING

Please contact your doctor ASAP and seek in-person care immediately if a side effect becomes problematic or you experience:

• Severe nausea and/or vomiting resulting in dehydration-  it is important to stay well hydrated and drink plenty of fluids while on this medication 
• Kidney problems/kidney failure - vomiting, nausea, diarrhea can cause dehydration and kidney issues and make kidney problems worse in individuals who have pre-existing kidney conditions; may sometimes lead to the need for hemodialysis 
• Thyroid C-Cell Tumor: Trouble swallowing, hoarseness, a lump or swelling in your neck, or shortness of breath (see black box warning below)
• Pancreatitis: Severe pain in your abdomen or back that will not go away 
• Acute gallbladder disease - Pain in the middle or right upper stomach, fever, white parts of your eyes turn yellow or skin turns yellow, nausea/vomiting. If gallstones or inflammation of the gallbladder is suspected further studies are needed.
• Hepatitis/Elevated liver enzymes/Jaundice
• Diabetic retinopathy problems: Changes in vision in those with type II diabetes, particularly vision problems may worsen in those with a history of diabetic retinopathy 
• Severe gastrointestinal disease - may cause gastrointestinal disease; do not use if you have a history of severe gastrointestinal disease 
• Signs of low blood sugar (for example, dizziness, weakness, shakiness, jitteriness, headache, anxiety/mood changes, rapid heartbeat, confusion, slurred speech, sweating, or lightheadedness). While this is rare with GLP-1s, if it occurs, please seek in-person care immediately. If you have these symptoms, try having liquid or food containing sugar (around 15-20 grams) —drinking juice, having regular soda, or eating some hard candies right away, as this will help raise your blood sugar quickly. If taken with insulin or an insulin secretagogue (ie sulfonylurea) it is best to talk to your healthcare provider about possibly lowering the dose of these medications to lower the risk of hypoglycemia. 
• Increasing heart rate
• Worsening depression, behavior changes, or suicidality
• Never share the semaglutide with other people