Despite the stereotypes of drug-seeking behaviors and narratives of illicit opioid use dominating the public perception of the opioid epidemic, the fact remains that a sizable portion of people who develop opioid use disorder start using opioids because of a medical prescription.
While it might come as a surprise, one group who is at higher risk of developing an opioid use disorder is people with diabetes. There are a number of reasons for this, with the most prominent being the need to treat chronic pain after developing diabetic neuropathy (pain resulting from nerve damage) as a side effect of insulin resistance.
Because of this overlap, there may be a greater-than-average number of diabetics in need of both treatment for diabetes and opioid use. Treating two serious conditions at once is a delicate process and may require careful application and adjustment of multiple medications.
People with Type 2 diabetes who also use opioids may find themselves prescribed both Ozempic® and Suboxone®, in which case it’s crucial to know how the drugs work, what the side effects of Ozempic and Suboxone are individually, and how they interact when taken together (important safety information). This guide offers a look at how both drugs are used, what patients need to know when taking both, and how to stay safe with Type 2 diabetes while undergoing Suboxone treatment.
What is Ozempic?
Also known by its generic name of semaglutide, Ozempic is a glucagon-like peptide-1 (GLP-1) agonist taken by subcutaneous (under the skin) injection to treat Type 2 diabetes. The drug works by binding to GLP-1 receptors, where it stimulates the pancreas to increase natural insulin production while also inhibiting the liver from overproducing sugars, leading to lower overall blood sugar.
Ozempic also causes the body to slow the rate at which it processes food, so the sugars that naturally result from digestion are released more evenly and over a longer period of time. By slowing this process down, you’ll also feel full for longer after eating, leading to some people using Ozempic as a weight-loss drug, though this use is off-label and not approved by the FDA.
In addition to helping manage blood sugar levels, Ozempic can also reduce the risk of major cardiovascular problems, such as heart attacks and strokes. It may also help to lower blood pressure and LDL cholesterol.
Ozempic is usually self-administered as a weekly injection in the upper arm, abdomen, or thigh, and doses range from 0.25 mg to 2 mg per injection.
Side effects of Ozempic
Ozempic comes with a boxed label warning, the most serious warning issued by the FDA. In animal studies, the drug has been shown to increase the risk of thyroid cancer. There is not yet conclusive evidence that this increased risk carries over to human patients, but doctors are unlikely to prescribe Ozempic to individuals who are already at an above-average risk for certain types of thyroid cancer.
The lesser side effects of Ozempic include:
- Headache
- Dizziness
- Nausea
- Constipation
- Loss of appetite
- Heartburn
- Bloating
- Sore throat
These side effects are all considered normal and don’t warrant immediate medical attention, but you may still want to talk to your doctor about adjusting your dose or cutting Ozempic entirely if these side effects are persistent or severe.
You should contact your doctor if you experience any of the more serious side effects of Ozempic, including:
- Lightheadedness
- Mood changes
- Thoughts of self-harm
- Fluttering in your chest
- Signs of a thyroid tumor
- Low blood sugar
- Vomiting
- Stomach pain
- Stomach flu symptoms
- Diarrhea
- Severe stomach and back pains (which may be signs of pancreatitis)
- Jaundice
- Fever
Suboxone’s effect on the body
Suboxone is the brand name of a combination of buprenorphine and naloxone and is considered the gold standard of care for opioid use disorder (OUD) treatment. Buprenorphine is an opioid that works slightly differently from most other drugs of its type, allowing it to be used to manage withdrawal and opioid cravings without producing the same euphoric effects of other opioids. Naloxone is an opioid antagonist and can be used to reverse the effects of an opioid overdose by bonding to opioid receptors and preventing opioids from being absorbed in the brain.
Suboxone has many of the same side effects as other opioids, but the ones most relevant to patients taking Ozempic are Suboxone’s impact on blood pressure and its relationship to cholesterol. While many people may think that Suboxone increases blood pressure, this is most likely due to its association with the withdrawal symptoms many patients experience before or when starting Suboxone treatment. In fact, Suboxone is a nervous system depressant and causes the respiratory and cardiovascular systems to slow down, potentially leading to low blood pressure. Suboxone has also been shown to cause low cholesterol.
How Ozempic interacts with Suboxone
At the moment, there is little evidence of negative interactions between Ozempic and Suboxone, but the area has not yet been thoroughly researched because semaglutide medications are relatively new to the market. Since both Suboxone and Ozempic lower blood pressure and cholesterol, it’s possible that these effects may be additive, leading to significant reductions in one or both metrics over time.
When taking the two drugs together, you should keep a close eye on both your blood pressure and your cholesterol. Serious drops in either or both is a sign that the drugs are causing an increased effect, and you may need to adjust your dosages.
While Suboxone generally has few and minimal interactions with other drugs, you can never be too careful when mixing prescriptions. Always consult with your physician and let them know exactly what prescriptions you’re taking before starting a new medication.
Get up-to-date guidance from Ophelia
Navigating medication interactions can be tricky, which is why Ophelia connects each patient with a dedicated care team. Our process starts with getting to know you, including any prescription medications you might already be taking, to ensure your OUD treatment program is tailored to your real life. We provide comprehensive real-time support and can adjust your care plan as needed so you don’t have to worry about medication interactions—our research-backed care is meant to keep you safe, no matter how your life changes.
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