Semglee Drug Interactions: What to Avoid and What to Tell Your Doctor

Updated:

February 18, 2026

Author:

Peter Daggett

Summarize this blog with AI:

Learn which medications, supplements, and foods can interact with Semglee (insulin glargine). Know what to avoid and what to tell your doctor.

Semglee Drug Interactions: What You Need to Know

When you take Semglee (Insulin Glargine-yfgn) to manage your diabetes, other medications, supplements, and even certain foods can affect how well it works — or increase your risk of side effects. Understanding these interactions helps you stay safe and keep your blood sugar under control.

This guide covers the most important Semglee drug interactions and what to tell your doctor.

How Drug Interactions Work with Insulin

Drug interactions with Semglee generally fall into two categories:

  • Medications that increase the risk of low blood sugar (hypoglycemia) — These either boost insulin's effects or lower blood sugar on their own, making dangerous drops more likely when combined with Semglee.
  • Medications that raise blood sugar — These can counteract Semglee's effects, making it harder to control your diabetes and potentially requiring a dose adjustment.

Neither type means you can't take the medication — but your doctor needs to know so they can adjust doses and monitor you appropriately.

Major Drug Interactions

These are the most clinically significant interactions with Semglee:

Other Diabetes Medications

Using Semglee with other blood sugar-lowering drugs increases the risk of hypoglycemia. This includes:

  • Sulfonylureas (Glipizide, Glyburide, Glimepiride) — These stimulate your pancreas to release more insulin. Combined with Semglee, the extra insulin can cause blood sugar to drop too low.
  • Metformin (Glucophage) — While the hypoglycemia risk with Metformin alone is low, it increases when combined with insulin.
  • GLP-1 receptor agonists (Ozempic/Semaglutide, Trulicity/Dulaglutide, Mounjaro/Tirzepatide) — These lower blood sugar and slow digestion. When used with Semglee, your doctor will likely start with a lower insulin dose.

Thiazolidinediones (TZDs)

Pioglitazone (Actos) and Rosiglitazone (Avandia) increase insulin sensitivity, but they can also cause fluid retention. When combined with Semglee, the risk of heart failure and edema increases. Your doctor should monitor for shortness of breath, swelling, and rapid weight gain.

Beta-Blockers

Medications like Metoprolol (Lopressor), Atenolol (Tenormin), and Propranolol (Inderal) can mask the symptoms of low blood sugar. Normally, your body signals hypoglycemia with a fast heartbeat and shakiness — beta-blockers can hide these warning signs. If you take a beta-blocker with Semglee, you'll need to check your blood sugar more frequently.

ACE Inhibitors and ARBs

Blood pressure medications like Lisinopril (Zestril), Enalapril (Vasotec), and Losartan (Cozaar) can increase insulin sensitivity, potentially increasing hypoglycemia risk. These are commonly prescribed alongside insulin for people with diabetes, so your doctor will monitor your blood sugar levels.

Corticosteroids

Prednisone, Dexamethasone, Methylprednisolone, and other steroids can significantly raise blood sugar. If you're prescribed a steroid (for asthma, inflammation, or other conditions), your Semglee dose may need to be temporarily increased. Alert your doctor whenever you start or stop a corticosteroid.

Sympathomimetics

Medications like Epinephrine (EpiPen) and Albuterol (ProAir, Ventolin) can raise blood sugar. If you use a rescue inhaler for asthma, be aware that it may temporarily increase your glucose levels.

Moderate Drug Interactions

  • MAO inhibitors — Older antidepressants like Phenelzine (Nardil) and Tranylcypromine (Parnate) can increase insulin sensitivity and raise hypoglycemia risk.
  • Fluoroquinolone antibiotics — Ciprofloxacin (Cipro) and Levofloxacin (Levaquin) can cause unpredictable blood sugar swings — both highs and lows. Monitor closely if prescribed these antibiotics.
  • High-dose aspirin (Salicylates) — Regular low-dose aspirin is typically fine, but high doses (used for pain or inflammation) can increase hypoglycemia risk.
  • Atypical antipsychotics — Olanzapine (Zyprexa) and Clozapine (Clozaril) can raise blood sugar, potentially reducing Semglee's effectiveness. Your doctor may need to adjust your insulin dose.

Supplements and Over-the-Counter Medications to Watch

Some OTC products and supplements can affect blood sugar:

  • Cinnamon supplements — May lower blood sugar slightly. Unlikely to cause problems alone, but worth mentioning to your doctor.
  • Chromium — May increase insulin sensitivity. Tell your doctor if you take chromium supplements.
  • Decongestants (Pseudoephedrine, Phenylephrine) — Found in cold and sinus medications, these can raise blood sugar. Check labels carefully.
  • Niacin (Vitamin B3) — High doses can increase blood glucose.

Always tell your doctor and pharmacist about all supplements you take, even if they seem harmless.

Food and Drink Interactions

Alcohol

Alcohol is the most important food-related interaction with Semglee. It can increase the risk of hypoglycemia, sometimes severely. Alcohol blocks your liver from releasing stored glucose, which means your body can't correct low blood sugar as easily.

If you drink alcohol:

  • Never drink on an empty stomach.
  • Monitor your blood sugar before, during, and after drinking.
  • Stick to moderate amounts.
  • Be aware that symptoms of low blood sugar can look like intoxication — others might not realize you need help.

Carbohydrate Intake

While not a "drug interaction," your carbohydrate intake directly affects how much Semglee you need. Significant changes in diet (starting a low-carb diet, for example) can require dose adjustments. Always talk to your doctor before making major dietary changes.

What to Tell Your Doctor

Before starting Semglee — and at every visit — make sure your doctor knows about:

  • All prescription medications you take
  • Over-the-counter medications, including pain relievers, cold medicines, and allergy pills
  • All vitamins and supplements
  • Any herbal remedies
  • Your alcohol use
  • Recent diet changes
  • New medications prescribed by other doctors

Keeping an updated medication list in your phone or wallet makes this easy. Your pharmacist is also a great resource — they can check for interactions every time you fill a prescription.

Final Thoughts

Drug interactions with Semglee are manageable, but they require awareness. The biggest risks come from other blood sugar-lowering medications, beta-blockers that hide hypoglycemia symptoms, and corticosteroids that raise blood sugar.

The best protection is communication. Keep your healthcare team informed about everything you take, and don't hesitate to ask questions.

For more on using Semglee safely, read about side effects to watch for. And if you need help finding Semglee at a pharmacy, Medfinder can help you check stock near you.

Can I take Metformin with Semglee?

Yes. Metformin and Semglee are commonly prescribed together for Type 2 diabetes. However, the combination increases hypoglycemia risk slightly, so your doctor will monitor your blood sugar and may adjust doses accordingly.

Does alcohol interact with Semglee?

Yes. Alcohol can increase the risk of hypoglycemia (low blood sugar) when taking Semglee. It blocks your liver from releasing stored glucose. If you drink, do so in moderation, never on an empty stomach, and monitor your blood sugar closely.

Can cold medicine affect Semglee?

Yes. Decongestants like pseudoephedrine and phenylephrine, found in many cold and sinus medications, can raise blood sugar. Check labels and talk to your pharmacist before taking OTC cold medications while on Semglee.

Should I tell my doctor about supplements if I take Semglee?

Yes. Supplements like chromium, cinnamon, and high-dose niacin can affect blood sugar levels. Always share a complete list of everything you take — including vitamins and herbal remedies — with your doctor and pharmacist.

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