RYBELSUS

SEMAGLUTIDE (SEM a GLOO tide) treats type 2 diabetes. It works by increasing insulin levels in your body, which decreases your blood sugar (glucose). It also reduces the amount of sugar released into the blood and slows down your digestion. Changes to diet and exercise are often combined with this medication.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

Take this medication by mouth. Take it as directed on the prescription label at the same time every day. Take the dose right after waking up. Do not eat or drink anything before taking it. Do not take it with any other drink except a glass of plain water that is less than 4 ounces (less than 120 mL). Do not cut, crush or chew this medication. Swallow the tablets whole. After taking it, do not eat breakfast, drink, or take any other medications or vitamins for at least 30 minutes. Keep taking it unless your care team tells you to stop.
A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.
Talk to your care team about the use of this medication in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
NOTE: This medicine is only for you. Do not share this medicine with others.

What may interact with this medication?
-Aminophylline
-Carbamazepine
-Cyclosporine
-Digoxin
-Levothyroxine
-Other medications for diabetes
-Phenytoin
-Tacrolimus
-Theophylline
-Warfarin
Many medications may cause changes in blood sugar, these include:
-Alcohol containing beverages
-Antiviral medications for HIV or AIDS
-Aspirin and aspirin-like medications
-Certain medications for blood pressure, heart disease, irregular heart beat
-Chromium
-Diuretics
-Female hormones, such as estrogens or progestins, birth control pills
-Fenofibrate
-Gemfibrozil
-Isoniazid
-Lanreotide
-Male hormones or anabolic steroids
-MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate
-Medications for weight loss
-Medications for allergies, asthma, cold, or cough
-Medications for depression, anxiety, or psychotic disturbances
-Niacin
-Nicotine
-NSAIDs, medications for pain and inflammation, like ibuprofen or naproxen
-Octreotide
-Pasireotide
-Pentamidine
-Phenytoin
-Probenecid
-Quinolone antibiotics such as ciprofloxacin, levofloxacin, ofloxacin
-Some herbal dietary supplements
-Steroid medications such as prednisone or cortisone
-Sulfamethoxazole; trimethoprim
-Thyroid hormones
Some medications can hide the warning symptoms of low blood sugar (hypoglycemia). You may need to monitor your blood sugar more closely if you are taking one of these medications. These include:
-Beta-blockers, often used for high blood pressure or heart problems (examples include atenolol, metoprolol, propranolol)
-Clonidine
-Guanethidine
-Reserpine

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

Visit your care team for regular checks on your progress.
Check with your care team if you have severe diarrhea, nausea, and vomiting, or if you sweat a lot. The loss of too much body fluid may make it dangerous for you to take this medication.
A test called the HbA1C (A1C) will be monitored. This is a simple blood test. It measures your blood sugar control over the last 2 to 3 months. You will receive this test every 3 to 6 months.
Learn how to check your blood sugar. Learn the symptoms of low and high blood sugar and how to manage them.
Always carry a quick-source of sugar with you in case you have symptoms of low blood sugar. Examples include hard sugar candy or glucose tablets. Make sure others know that you can choke if you eat or drink when you develop serious symptoms of low blood sugar, such as seizures or unconsciousness. Get medical help at once.
Tell your care team if you have high blood sugar. You might need to change the dose of your medication. If you are sick or exercising more than usual, you might need to change the dose of your medication.
Do not skip meals. Ask your care team if you should avoid alcohol. Many nonprescription cough and cold products contain sugar or alcohol. These can affect blood sugar.
Wear a medical ID bracelet or chain. Carry a card that describes your condition. List the medications and doses you take on the card.
Do not become pregnant while taking this medication. Women should inform their care team if they wish to become pregnant or think they might be pregnant. There is a potential for serious side effects to an unborn child. Talk to your care team for more information. Do not breast-feed an infant while taking this medication.

If you miss a dose, skip it. Take your next dose at the normal time. Do not take extra or 2 doses at the same time to make up for the missed dose.

Side effects that you should report to your care team as soon as possible:
-Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
-Change in vision
-Dehydration—increased thirst, dry mouth, feeling faint or lightheaded, headache, dark yellow or brown urine
-Gallbladder problems—severe stomach pain, nausea, vomiting, fever
-Heart palpitations—rapid, pounding, or irregular heartbeat
-Kidney injury—decrease in the amount of urine, swelling of the ankles, hands, or feet
-Pancreatitis—severe stomach pain that spreads to your back or gets worse after eating or when touched, fever, nausea, vomiting
-Thyroid cancer—new mass or lump in the neck, pain or trouble swallowing, trouble breathing, hoarseness
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
-Diarrhea
-Loss of appetite
-Nausea
-Stomach pain
-Vomiting

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Keep out of the reach of children and pets.
Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F). Keep this medication in the original container. Protect from moisture. Keep the container tightly closed. Get rid of any unused medication after the expiration date.
To get rid of medications that are no longer needed or have expired:
-Take the medication to a medication take-back program. Check with your pharmacy or law enforcement to find a location.
-If you cannot return the medication, check the label or package insert to see if the medication should be thrown out in the garbage or flushed down the toilet. If you are not sure, ask your care team. If it is safe to put it in the trash, take the medication out of the container. Mix the medication with cat litter, dirt, coffee grounds, or other unwanted substance. Seal the mixture in a bag or container. Put it in the trash.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.