Topic summary

Oral contraceptives and delayed emptying: what the data shows

Practice › Interactions metformin delayed gastric emptying insulin Solved

This is a generated summary. It shows the 9 most-liked posts from a topic of 72, in their original order, with the accepted answer included where one exists. It is a reading aid and it will miss nuance — the full topic is the record.

b.vanheckeTL2 Moderator5 Jul 2024#5

d.eriksen, post #3: Picking up post #2: that is the part I would want checked first. Oral medications versus time: if you take an oral medication 30 minutes before semaglutide (which slows gastric emptying), the delayed stomach emptying affects when and where the oral medication is absorbed. Separating by a larger interval (1 to 2 hours) usually resolves… Go to post

Food interactions: most interactions are absorption interactions. Some medications absorb better with food, others better on an empty stomach. With an incretin agonist that already slows gastric emptying, food effects interact with the drug effect as well.

29 likes in reply to #3 2.1y

vial_slopeTL3Regular Solution6 Jul 2024#9

Thyroid medications: semaglutide is associated with a slowing of gastric emptying, which might affect thyroid medication absorption if they are taken very close together. Separating them by a few hours is the conservative approach.

22 likes 2.1y

l.aaltonenTL3Regular7 Jul 2024#14

post #13 answers the question as asked. The question underneath it is different.

Metformin: commonly co-administered and relevant to gastrointestinal tolerability. Gastrointestinal side effects can overlap and additive. Taking them separately or adjusting one if tolerability is poor are reasonable approaches.

32 likes 2.1y

c.ostergaardTL2 Moderator9 Jul 2024#22

Alcohol: no absolute contraindication but it raises gastrointestinal irritation risk and this drug class already does that. The conservative position during titration is to limit it.

29 likes 2.1y

s.vogelTL2 Moderator13 Jul 2024#38

e.pires, post #23: SGLT2 inhibitors: frequently co-administered and relevant to renal and cardiovascular discussion, not to interactions. There is no pharmacokinetic interaction of concern. Go to post

Anticoagulants: no direct interaction with the compounds in this class. Weight loss and body composition changes might affect the clearance or effect of warfarin if you are on it; monitoring INR more frequently during weight loss is reasonable.

27 likes in reply to #23 2y

ar.petrovTL2 Moderator14 Jul 2024 · edited#42

32 likes 2y

j.mwangiTL4 Moderator16 Jul 2024 · edited#54

post #53 is right about the mechanism and I think understates the practical bit.

Sulfonylureas and meglitinides: these agents stimulate insulin release and carry hypoglycemia risk. Combining them with semaglutide or tirzepatide requires dose adjustment of the secretagogue and close monitoring. The combination is not contraindicated but requires active management.

30 likes 2y

slow_titratorTL2Regular19 Jul 2024#70

I read post #68 twice before replying, because I had assumed the opposite.

Supplements and herbs: many have no established interaction. Some do. If you are taking something unusual, checking a reference (like a pharmacist) is more useful than guessing from forum discussion.

30 likes 2y

m.lindqvistTL2 Moderator19 Jul 2024#71

Worth separating two things that post #67 runs together.

Separation timing versus clinically important interaction: a separation timing inconvenience (taking one medication 2 hours before or after another) is not the same as a clinically important interaction. Both can reduce absorption of one or the other, but only true interactions require active management.

25 likes 2y

Read the full topic (72 posts)

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