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HealthRX.com · Printable surgery planning sheet

Wegovy contrast-scan prep sheet: contrast type, kidney risk factors and sedation

Fill this in when the scan is booked: which contrast and whether you will be sedated, the kidney risk factors the ACR manual lists, your recent stomach symptoms and your last Wegovy dose. Hand it to the scheduler or radiology nurse.

Companion to “Wegovy and Imaging Contrast Dye: What Patients and Clinicians Need to Know” · healthrx.com/interactions-wegovy/contrast-dye-interaction · Facts checked 2026-10-19

The scan

Date and time
Scan typeCT, MRI, angiography, catheterization
Contrastiodinated or gadolinium; agent name if known
Sedation or anesthesia planned?
Last Wegovy dose: date, form and strength
Ordering clinician and contact

Kidney risk factors the ACR manual lists: tick any that apply

  • Known chronic kidney disease
  • Acute kidney injury in the past
  • Dialysis
  • Kidney surgery or kidney ablation
  • Albumin (protein) in the urine
  • Metformin, alone or in a combination tablet
  • Diabetes (listed as optional)

Stomach symptoms in the last week

Vomiting: days and roughly how often
Diarrhea: days and roughly how often
Keeping fluids down?yes / no / only some

Points from the ACR manual and the Wegovy label

  • Routine iodinated contrast without a listed kidney risk factor does not need a baseline creatinine.[1]
  • With a group II gadolinium agent at standard doses, a kidney check before MRI contrast is optional.[1]
  • Not all studies have shown dehydration to be a major risk factor for kidney injury after contrast.[1]
  • Severe stomach reactions were reported in 4.1% of adults on Wegovy injection and 0.9% on placebo.[2]
  • Tell your healthcare providers before any planned procedure that you take Wegovy.[2]

Before or after the scan, call right away for

  • Severe stomach pain that will not go away, with or without nausea or vomiting: stop Wegovy and call your healthcare provider right away.[2]
  • Nausea, vomiting or diarrhea that does not go away: tell your healthcare provider right away; fluid loss can cause kidney problems.[2]
Sources for the facts on this sheet
  1. American College of Radiology Committee on Drugs and Contrast Media. ACR Manual on Contrast Media 2026. Accessed 2026-10-19. https://edge.sitecorecloud.io/americancoldf5f-acrorgf92a-productioncb02-3650/media/ACR/Files/Clinical/Contrast-Manual/ACR-Manual-on-Contrast-Media.pdf
  2. Novo Nordisk, via DailyMed. Wegovy (semaglutide) injection, for subcutaneous use, and Wegovy (semaglutide) tablets, for oral use: prescribing information and Medication Guide. Effective 2026-06-18. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ee06186f-2aa3-4990-a760-757579d8f77b

This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.