Can I take Bisoprolol and Rybelsus (semaglutide) together?

Why this happens

Bisoprolol is a beta-blocker that works by slowing the heart rate and blocking the effects of adrenaline. Adrenaline is the hormone responsible for the 'shaky' feeling and racing heart you get when your blood sugar drops too low. By blocking these signals, the drug 'masks' the symptoms of low blood sugar. Furthermore, beta-blockers can sometimes interfere with the release of insulin and the body's ability to release stored sugar from the liver.

What you should do

You can take these medicines together, but you should be extra vigilant. Since you may not feel a racing heart if your blood sugar drops, look out for other signs of a 'hypo' that bisoprolol doesn't mask, such as sweating, dizziness, hunger, or confusion. It is a good idea to monitor your blood sugar levels more frequently when starting or changing the dose of either medication. Discuss a plan with your doctor or pharmacist on what to do if your blood sugar levels become unstable.

Important precautions

Asthma or chronic obstructive pulmonary disease (COPD)

Bisoprolol can cause your airways to narrow, making it much harder to breathe or triggering a severe asthma attack. It is usually avoided if you have a history of wheezing or asthma.

Diabetes

Bisoprolol can mask the warning signs of low blood sugar (hypoglycaemia), such as a fast heartbeat or tremors. You will need to monitor your blood sugar more closely.

History of pancreatitis

Rybelsus increases the risk of inflamed pancreas (pancreatitis). You must stop treatment and seek urgent medical help if you develop severe, persistent stomach pain that may reach through to your back.

Food and drink warnings

Alcohol

Alcohol can increase the blood-pressure-lowering effect of bisoprolol, which may make you feel dizzy or lightheaded. For Rybelsus, alcohol can affect your blood sugar levels and may increase the risk of low blood sugar (hypoglycaemia) or stomach upset.

Food and Drink (General)

You must take Rybelsus on an empty stomach with a small sip of plain water (no more than 120ml). You must wait at least 30 minutes before eating, drinking anything else, or taking other oral medicines. If you eat or drink too soon, the medicine will not be absorbed properly and will not work.

Using other medicines

Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Disclaimer

This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.