Med of the Month: Semaglutide

At a recent continuing education lecture, our leaders Dr. Lisa Chan and Barbara Madej walked through what dental providers should know about GLP-1 medications. With prescriptions for this class of drugs rising at an unprecedented pace, we felt it was especially timely to spotlight semaglutide as this month’s Med of the Month.

Semaglutide, commonly known by its brand names Ozempic, Wegovy, and Rybelsus, is a glucagon-like peptide-1 receptor agonist brought to market by Novo Nordisk in 2017.

Generic Name: Semaglutide 

Brand Name(s): Ozempic, Wegovy, Rybelsus

Pronunciation: SEM a GLOO tide

About this drug:

• Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1) that:

  • (Rybelsus and Ozempic brands) Improves blood sugar in adults with type 2 diabetes.

  • (Wegovy brand) Controls weight in children aged 12 years and older with obesity and in adults with obesity plus other comorbidities: type 2 diabetes, high cholesterol, or high blood pressure.

  • Is not a substitute for insulin and is not for use in people with type 1 diabetes or diabetic ketoacidosis

Feature	Ozempic	Wegovy	Rybelsus
Route	Injection	Injection	Oral tablet
Frequency	Weekly	Weekly	Daily
Max dose	2 mg	2.4 mg	14 mg
FDA indication	Type 2 diabetes	Obesity/weight loss	Type 2 diabetes
Cardiovascular approval	Yes	Yes (SELECT trial)	Limited

Dentistry-related tidbits:

• If you’re treating a patient taking semaglutide, a few patterns are worth keeping top of mind in the operatory:

  • Oral side effects: You may start to notice dental erosion, particularly on the palatal surfaces of maxillary anterior teeth. This is often tied to nausea, vomiting, and gastric acid reflux, which are common when patients first start the medication or increase their dose. Xerostomia can also show up, increasing caries risk. In these cases, recommending or prescribing Prevident can be helpful. Some patients report dysgeusia as well; if it becomes significant, it’s worth looping in their prescribing provider to consider alternatives.

  • Epinephrine considerations: Semaglutide can increase heart rate by about 1-10 bpm. In patients with pre-existing cardiac conditions, adding exogenous epinephrine may raise concerns. If there’s a cardiac history, consult the patient’s cardiologist before proceeding. Otherwise, use the minimum effective epinephrine concentration (1:200,000 or lower), limit vasoconstrictor dose, aspirate carefully, and inject slowly.

  • Cancer risk: Medullary thyroid carcinoma (MTC) has been reported in rodent studies. Semaglutide is contraindicated in patients with a personal or family history of MTC, or in those with multiple endocrine neoplasia type 2 (MEN2). For patients on semaglutide, incorporating a thyroid exam into your assessment is recommended.

  • Procedure planning: This medication should be temporarily suspended for surgical procedures, x-rays, or CT scans that use contrast dye (with the exception of minor procedures not associated with restricted intake of food and fluids). It should not be restarted until normal oral intake resumes. Always consult the patient’s physician before making changes.

  • Aspiration risk: Pulmonary aspiration has been reported in patients receiving GLP-1 receptor agonists who are undergoing elective surgeries or procedures requiring general anesthesia or deep sedation.

Staying Safe: important interactions to be aware of

• Using a tool like MedAssent DDS Rx Check can help support safe prescribing. Important interactions include:

  • Exercise caution when prescribing steroids alongside semaglutide, as this combination may increase the risk of hyperglycemia.

  • Quinolone antibiotics such as ciprofloxacin, levofloxacin, moxifloxacin, and ofloxacin may increase the risk of severe hypoglycemia or hyperglycemia when used with semaglutide. Encourage patients to monitor their blood sugar closely.

  • Combining clarithromycin or tramadol with semaglutide may also increase the risk of severe hypoglycemia.

Fun facts:

• GLP-1 prescriptions in the U.S. have increased by nearly 600% between 2020 and 2023.

• First-time prescribing of anti-obesity semaglutide rose more than 50% from December 2025 to March 2026.

• Emerging therapeutic roles for GLP-1s include liver disease, obstructive sleep apnea, knee osteoarthritis, polycystic ovary syndrome, and substance use disorders.

• Early studies suggest a possible reduction in periodontal disease progression; however, weight loss alone improves inflammatory markers, so more research is still needed.

Get more dental-specific drug information with the Digital Drug Handbook (web) or BrushUp Rx (mobile app).