Altered Medication Absorption/Efficacy (for other drugs)
Users on Reddit report a variety of experiences regarding altered absorption or efficacy of other medications while taking GLP-1 drugs. These changes are often attributed to delayed gastric emptying, a known effect of GLP-1 agonists. Users also share strategies they've employed, often in consultation with their doctors, to manage these interactions.
Experiences with Altered Medication Absorption/Efficacy:
Many Type 1 diabetic users report a significant reduction in their insulin needs (both basal and bolus) after starting GLP-1s. One user on Mounjaro noted their mealtime insulin went from "~40 units with meals before. Down to 10-12. "[34] Another on a higher dose of Mounjaro stated, "I'm at over a 50% decrease in my basal and about a 95% decrease for my rapid acting insulin... most days I only take basal. "[15]
Delayed gastric emptying causes food to digest slower, leading to delayed blood sugar spikes. An OP described, "my BS shot up to well over 300 mg/dl and I have been having an extremely difficult time getting it to come down... I am wondering since GLP-1s slow down gastric emptying that the food I ate throughout the day yesterday digested slower and late last night/early morning just hit like a ton of bricks. "[4] This makes insulin timing challenging, with users needing to adjust strategies, such as no longer pre-bolusing or using extended boluses. [11, 12]
The effectiveness of standard hypoglycemia treatments can be diminished. One user found, "Solid food is useless at raising my sugars now if low. I have to drink juice or some sugary liquid. Even the glucose tabs didnt seem very effective unless I chased them with water. "[7] Another echoed, "treating hypos is harder because of the delayed gastric emptying. For me drinking juice boxes works much quicker than sweets like I used to treat with. "[8]
Rapid weight loss on GLP-1s can sometimes lead to high ketones, which in turn can cause insulin resistance. [5]
Some users report GLP-1s helping with conditions like reactive hypoglycemia. One user mentioned, "Ozempic/wegovy at the lowest dose of 0. 25 cured it [severe reactive hypoglycemic events]. "[35]
GLP-1s can also affect how the liver releases glucose, with one user noting, "GLP-1 drugs suppress these [inappropriate releases of glucose by the liver] and are a big part of reducing basal insulin requirements. "[32]
Conversely, some users found GLP-1s had positive mental health effects, potentially reducing the need for other psychiatric drugs. One user on Zepbound reported it "Also helped with their OCD, weirdly enough. "[36] Another on tirzepatide shared, "It also helped my mental state, I’m now off my antidepressants and off my anti anxiety medicines. "[16]
Similarly, some users experienced reduced cravings for marijuana: "I’ve even cut back on weed cause the cravings aren’t there. "[21]
Mechanism: Delayed Gastric Emptying / Gastroparesis
Remedies and Preventions Recommended by Users:
Bolus Strategy Changes: Adapting to delayed digestion by, for example, "had to use extended bolus for everything I ate in the first few weeks," especially for denser meals. [11] Or, as another found, "no need to pre-bolus for meals really. "[12]
Dietary Adjustments: Some find a "low carb as worked for me" approach helpful. [6] Others identify specific problematic foods: "Peanut butter is just a hard no... it took 4-6 hours for it to even start showing up on my meter. "[7]
Hypoglycemia Treatment: Switching to "juice or some sugary liquid" for lows as solid foods/tabs may absorb too slowly. [7, 8]
Ketone Monitoring & Management: If experiencing rapid weight loss, "It could be worth testing for ketones... Eat some carbs and drink a ton of water if so! "[5]
Automated Insulin Delivery: A loop system helped one user, as "It slows down the after-meal spikes so that the loop can get them under control. "[10]
Hydration: Increasing fluid intake is frequently advised. [18, 27]
Dietary Management for GI Issues: Eating smaller meals and avoiding foods that trigger severe GI side effects like heavy carbs. [28, 29] One user whose friend had constipation was advised by her doctor "to stop eating so much so she did, and the constipation went away. "[28]
Fiber and Probiotics: To manage constipation, users recommend "Metamucil"[30], "4g fiber gummies morning and night"[31], or a "glp-1 probiotic daily (pill form). "[25]
The primary implied remedy is close medical supervision and re-evaluation of the other medications. The user experiencing issues with valproate had their dose adjusted by a doctor, though this had further complications, highlighting the complexity. [1] Users who stopped antidepressants did so due to improved mental state, presumably in discussion with their healthcare providers. [16]
It's important to note that these are user-reported experiences and recommendations, and individuals should always consult with their healthcare providers regarding medication management while on GLP-1s.
Experiences with Altered Medication Absorption/Efficacy:
- Insulin and Diabetes Management Medications: This is the most frequently discussed area.
- Psychiatric Medications:
- A user described a concerning experience with valproate: "Semaglutide —> 70 lbs weight loss —> sky rocketing tremors on prior stable valproate —> mania emerges as dose is reduced.
- Alcohol and Marijuana:
- A common report is a reduced desire for or enjoyment of alcohol.
- General Reduction in Need for Other Prescriptions:
- Some users found they needed fewer medications overall.
- Anti-nausea Medications:
- One user with dysautonomia found that even with anti-nausea medication, the nausea from GLP-1s could be severe: "The nausea was bad, even though I was on medication for it.
Mechanism: Delayed Gastric Emptying / Gastroparesis
- The primary mechanism users and medical professionals point to for altered medication absorption is delayed gastric emptying, sometimes referred to as gastroparesis.
Remedies and Preventions Recommended by Users:
- For Insulin and Diabetes Management:
- Insulin Dose Adjustment: Regularly monitoring blood sugar and significantly adjusting (usually reducing) insulin doses in consultation with a doctor is crucial.
- General Strategies for Managing GLP-1s (which may mitigate issues with other medications):
- Slow Titration & Dose Adjustment: Starting with the lowest possible dose or even "micro dose and ride out the efficacy of each shot before tirating up.
- For Other Medications (e.
It's important to note that these are user-reported experiences and recommendations, and individuals should always consult with their healthcare providers regarding medication management while on GLP-1s.