Rapid Rx Quiz: Semaglutide

Mary L. Windle, PharmD


January 20, 2022

In rodents, semaglutide causes dose-dependent and treatment-duration–dependent thyroid C-cell tumors at clinically relevant exposures; it is unknown whether it causes these tumors, including medullary thyroid carcinoma (MTC), in humans because the human relevance of semaglutide-induced rodent thyroid C-cell tumors has not been determined. However, semaglutide is contraindicated in patients with a personal or family history of MTC or in patients with multiple endocrine neoplasia syndrome type 2. Advise patients of the potential risk for MTC with semaglutide and the possible symptoms of thyroid tumors (eg, a mass in the neck, dysphagia, dyspnea, persistent hoarseness).

Hypertension, along with dyslipidemia and T2D, is one of the weight-related comorbid conditions in overweight adults that indicates that use of semaglutide might be appropriate. Semaglutide, specifically Wegovy, is indicated as an adjunct to a reduced calorie diet and increased physical activity for chronic weight management in adults with an initial body mass index of 30 or greater (obesity) or 27 or greater (overweight) in the presence of at least 1 weight-related comorbid condition.

Semaglutide is not contraindicated for patients with hypothyroidism. However, because semaglutide causes a delay of gastric emptying, it may affect the oral absorption of thyroid medications. Although heartburn has been reported as an adverse effect of semaglutide, it is not contraindicated in patients with gastroesophageal reflux disease.

Learn more about warnings for semaglutide use.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.