Ozempic and benzodiazepine pharmacist check sheet

Read these out to the pharmacist

Tick any of these you also take

These are the drug groups the Xanax label names as changing alprazolam levels or adding sedation.

• An azole antifungal such as ketoconazole or itraconazole
• Clarithromycin or erythromycin
• Nefazodone, fluvoxamine or cimetidine
• Ritonavir or another HIV protease inhibitor
• Carbamazepine
• An opioid painkiller or other opioid medicine
• Alcohol, or another sedating (CNS depressant) medicine

What the labels say

• Ozempic: lab studies showed very low potential for semaglutide to inhibit or induce CYP enzymes.[1]
• Ozempic: metformin, a birth control pill, warfarin, digoxin and atorvastatin showed no clinically relevant change in absorption; a benzodiazepine was not tested.[1]
• Xanax: ketoconazole made alprazolam exposure 3.98 times higher, and strong CYP3A inhibitors other than ritonavir are contraindicated with it.[2]
• Lorazepam: changed into lorazepam glucuronide and passed in urine.[3]
• Ozempic: rare aspiration has been reported in people on GLP-1 medicines having deep sedation or anesthesia who still had stomach contents despite fasting.[1]

Questions to ask

1. Is my benzodiazepine cleared through CYP3A, like alprazolam, or through glucuronidation, like lorazepam?
2. Does anything else I take change its blood level?
3. Does the team doing my procedure know I use both Ozempic and a benzodiazepine?
4. If an as-needed dose seems slow in the days after an Ozempic increase, what should I do instead of repeating it?