GLP-1 medication safety

Who should not take a GLP-1 medication

These medications are not appropriate for everyone. You should not take semaglutide or tirzepatide if any of the following apply to you:

• You or a family member has had medullary thyroid carcinoma (MTC)
• You have Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
• You have had a serious allergic reaction to semaglutide, tirzepatide, or any ingredient in the product
• You are pregnant, planning to become pregnant, or breastfeeding

Your provider will review your full history at your consultation. If a GLP-1 isn't right for you, we will tell you, and we'll talk through what else might be.

What to tell your provider before starting

Give your provider a complete picture. It directly affects whether this medication is safe for you and how you should be monitored. Tell us if you:

• Have or have had problems with your pancreas, gallbladder, or kidneys
• Have a history of pancreatitis
• Have type 1 or type 2 diabetes, and especially if you take insulin or a sulfonylurea
• Have diabetic retinopathy or other eye problems related to diabetes
• Have gastroparesis or other problems with digestion or stomach emptying
• Have a history of depression, mood changes, or suicidal thoughts or behavior
• Have a history of alcohol use disorder or substance use
• Are pregnant, breastfeeding, or planning a pregnancy
• Take any other medications, vitamins, or herbal supplements

Serious side effects

These are uncommon, but they matter. Know the warning signs.

Inflammation of the pancreas (pancreatitis)

Stop taking the medication and contact your provider immediately if you have severe abdominal pain that will not go away, with or without vomiting. The pain may spread from your abdomen to your back.

Gallbladder problems

Gallstones and gallbladder inflammation have occurred. Tell your provider if you have pain in your upper stomach, fever, yellowing of the skin or eyes, or clay-colored stools.

Low blood sugar (hypoglycemia)

The risk is higher if you also take insulin or a sulfonylurea. Signs include dizziness, blurred vision, shakiness, sweating, confusion, irritability, fast heartbeat, hunger, or weakness. Your provider may need to adjust your other diabetes medications.

Kidney injury

Nausea, vomiting, or diarrhea can lead to dehydration, which can cause kidney problems or worsen existing ones. Drink fluids and tell your provider if you can't keep liquids down.

Serious allergic reactions

Get emergency help for swelling of the face, lips, tongue, or throat; trouble breathing or swallowing; severe rash or itching; fainting or dizziness; or a very rapid heartbeat.

Changes in vision

Patients with type 2 diabetes and diabetic retinopathy have experienced worsening of that condition. Tell your provider about any changes in your vision.

Depression, mood changes, or suicidal thoughts

Pay attention to changes in mood, behavior, feelings, or thoughts. Call your provider right away if you experience new or worsening depression, or thoughts of harming yourself. If you are in immediate danger, call 911 or go to the nearest emergency room. You can also reach the 988 Suicide & Crisis Lifeline by calling or texting 988.

Stomach emptying problems

These medications slow how quickly food leaves your stomach. In some cases this has led to severe or persistent digestive problems, including intestinal blockage (ileus). Tell your provider about severe abdominal pain, ongoing vomiting, bloating, or constipation that doesn't resolve.

Increased heart rate

Tell your provider if you feel your heart racing or pounding at rest.

Common side effects

Most side effects are digestive, tend to appear when you start or increase your dose, and often ease over time as your body adjusts. The most commonly reported include:

• Nausea
• Diarrhea
• Vomiting
• Constipation
• Abdominal pain and bloating
• Indigestion, heartburn, or burping
• Headache, fatigue, or dizziness
• Gas
• Injection site reactions

This is not a complete list. Tell your provider about any side effect that bothers you or doesn't go away — dose adjustments are a normal part of treatment, and you should not simply endure symptoms.

Before surgery or any procedure with anesthesia

Pregnancy and breastfeeding

These medications may harm an unborn baby and should not be used during pregnancy. Tell your provider immediately if you become pregnant or think you might be.

If you are planning a pregnancy, talk to your provider about when to stop. Because semaglutide stays in the body for an extended period, it is generally discontinued at least two months before a planned pregnancy.

It is not known whether these medications pass into breast milk. Discuss breastfeeding with your provider before starting.

A note for patients using oral birth control: tirzepatide may reduce the effectiveness of oral contraceptives, particularly when you start treatment and after each dose increase. Talk to your provider about switching to a non-oral method or adding a barrier method during those periods.

Drug interactions

Because GLP-1 medications delay stomach emptying, they can affect how your body absorbs other medications you take by mouth. Give your provider and pharmacist a complete list of everything you take, including over-the-counter products, vitamins, and supplements.

Particular care is needed if you take insulin, a sulfonylurea, oral contraceptives, thyroid medication, or any drug where precise timing and blood levels matter.

About compounded medications

When to seek immediate medical care

For non-emergency questions about your treatment, call the clinic at (619) 765-4141 during business hours.

Reporting side effects

Tell your provider about any side effect you experience. You may also report side effects directly to the FDA at fda.gov/medwatch or by calling 1-800-FDA-1088.

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This page is a summary and does not list every possible risk, side effect, or interaction. It is general information, not medical advice, and it does not replace the Medication Guide provided with your prescription, the full prescribing information, or the individual guidance of your treating provider. Always talk to your provider about your specific situation before starting, stopping, or changing any medication.