Short answer: Semaglutide slows stomach emptying, which may change how pills are absorbed.
Semaglutide delays stomach emptying, so the labels say it may affect the absorption of medicines taken by mouth. In the drug studies in the label, injected semaglutide did not change absorption of the tested pills to a clinically relevant degree. The Wegovy label notes levothyroxine exposure rose 33% with the semaglutide tablet and advises closer monitoring for pills with a narrow safety margin.
The pills tested in the semaglutide label studies were metformin, an ethinylestradiol/levonorgestrel birth control pill, warfarin, digoxin and atorvastatin. Narrow-margin medicines are ones where a small change in blood level matters, such as warfarin or thyroid hormone. If you take one of these, ask the prescriber whether extra checks are needed when semaglutide is started or the dose changes.
FDA label. The interaction is described in the FDA-approved prescribing information for at least one of the two. Caution: There is a documented or likely risk to watch for, such as low blood sugar or added side effects. Talk to your prescriber before combining.
Guides: Semaglutide, Oral medications (pills). To check this pair alongside others, open it in the peptide interaction checker.