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The Ozempic prescribing information explicitly states: "Patients using oral medications that require threshold concentrations for efficacy should be monitored particularly closely during the first 4 weeks of semaglutide therapy." [3] Patients should be counseled on three practical points: take levothyroxine and other narrow-window drugs before other medications in the morning, keep injection day consistent but do not assume interaction risk disappears on non-injection days, and report any unusual symptoms (breakthrough bleeding on OC, fatigue suggesting hypothyroidism, unusual bruising suggesting INR shift) promptly

(Mayo Clinic) GLP-1 receptor agonists and risk of thyroid cancer: a systematic review and meta-analysis (Diabetes, Obesity and Metabolism) How to Buy Medicines Safely From an Online Pharmacy (FDA) BeSafeRx: Your Source for Online Pharmacy Information (FDA)

While semaglutide is safe for most people, there are potential side effects, which are typically mild and manageable

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It also reduces pressure in the kidneys and heart

Diabetes, Obesity & Metabolism, 19 (9), 12421251