{
  "dataset": "TruthStack GLP-1 Supplement Interaction Index",
  "version": "2026.1",
  "generated": "2026-02-18",
  "license": "CC-BY-4.0",
  "license_url": "https://creativecommons.org/licenses/by/4.0/",
  "attribution": "TruthStack (https://truthstack.co)",
  "attribution_required": true,
  "description": "Curated supplement-drug interaction data for GLP-1 receptor agonists (semaglutide, tirzepatide). Derived from published literature, FDA FAERS pharmacovigilance data, and CAERS adverse event reports. Population-level evidence summary — not individualized medical advice.",
  "methodology_url": "https://truthstack.co/evidence-methodology",
  "api_endpoint": "https://api.truthstack.co/v1/check",
  "compounds_covered": ["semaglutide", "tirzepatide"],
  "brand_names": {
    "semaglutide": ["Ozempic", "Wegovy", "Rybelsus"],
    "tirzepatide": ["Mounjaro", "Zepbound"]
  },
  "interaction_count": 68,
  "severity_levels": ["CRITICAL", "HIGH", "MODERATE", "LOW", "INFO"],
  "interactions": [
    {
      "compound_1": "berberine",
      "compound_2": "semaglutide",
      "interaction_type": "PHARMACODYNAMIC_RISK",
      "severity": "MODERATE",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Both berberine and semaglutide lower blood glucose through different mechanisms (AMPK activation vs GLP-1 receptor agonism). Combining them may increase hypoglycemia risk. Monitor blood glucose closely and discuss with prescriber.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/berberine-and-semaglutide",
      "last_updated": "2026-02-15"
    },
    {
      "compound_1": "berberine",
      "compound_2": "tirzepatide",
      "interaction_type": "PHARMACODYNAMIC_RISK",
      "severity": "MODERATE",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Both berberine and semaglutide lower blood glucose through different mechanisms (AMPK activation vs GLP-1 receptor agonism). Combining them may increase hypoglycemia risk. Monitor blood glucose closely and discuss with prescriber.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/berberine-and-tirzepatide",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "biotin",
      "compound_2": "semaglutide",
      "interaction_type": "BLEEDING_RISK",
      "severity": "MODERATE",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Monitor closely. 22 serious adverse events reported with this combination in FDA FAERS. Pharmacovigilance signal, not proof of causation. Discuss with prescriber.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/biotin-and-semaglutide",
      "last_updated": "2026-02-10"
    },
    {
      "compound_1": "biotin",
      "compound_2": "tirzepatide",
      "interaction_type": "BLEEDING_RISK",
      "severity": "MODERATE",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Monitor closely. 22 serious adverse events reported with this combination in FDA FAERS. Pharmacovigilance signal, not proof of causation. Discuss with prescriber.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/biotin-and-tirzepatide",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "calcium",
      "compound_2": "semaglutide",
      "interaction_type": "ANTAGONISTIC",
      "severity": "HIGH",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Monitor closely. 453 serious adverse events reported with this combination in FDA FAERS. Pharmacovigilance signal, not proof of causation. Discuss with prescriber.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/calcium-and-semaglutide",
      "last_updated": "2026-02-10"
    },
    {
      "compound_1": "calcium",
      "compound_2": "tirzepatide",
      "interaction_type": "ANTAGONISTIC",
      "severity": "HIGH",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Monitor closely. 453 serious adverse events reported with this combination in FDA FAERS. Pharmacovigilance signal, not proof of causation. Discuss with prescriber.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/calcium-and-tirzepatide",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "cbd",
      "compound_2": "semaglutide",
      "interaction_type": "ANTAGONISTIC",
      "severity": "LOW",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Monitor closely. 6 serious adverse events reported with this combination in FDA FAERS. Pharmacovigilance signal, not proof of causation. Discuss with prescriber.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/cbd-and-semaglutide",
      "last_updated": "2026-02-10"
    },
    {
      "compound_1": "cbd",
      "compound_2": "tirzepatide",
      "interaction_type": "ANTAGONISTIC",
      "severity": "LOW",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Monitor closely. 6 serious adverse events reported with this combination in FDA FAERS. Pharmacovigilance signal, not proof of causation. Discuss with prescriber.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/cbd-and-tirzepatide",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "coq10",
      "compound_2": "semaglutide",
      "interaction_type": "SAFETY_CONCERN",
      "severity": "MODERATE",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Monitor closely. 24 serious adverse events reported with this combination in FDA FAERS. Pharmacovigilance signal, not proof of causation. Discuss with prescriber.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/coq10-and-semaglutide",
      "last_updated": "2026-02-10"
    },
    {
      "compound_1": "coq10",
      "compound_2": "tirzepatide",
      "interaction_type": "SAFETY_CONCERN",
      "severity": "MODERATE",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Monitor closely. 24 serious adverse events reported with this combination in FDA FAERS. Pharmacovigilance signal, not proof of causation. Discuss with prescriber.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/coq10-and-tirzepatide",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "fish_oil",
      "compound_2": "semaglutide",
      "interaction_type": "BLEEDING_RISK",
      "severity": "HIGH",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Monitor closely. 62 serious adverse events reported with this combination in FDA FAERS. Pharmacovigilance signal, not proof of causation. Discuss with prescriber.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/fish-oil-and-semaglutide",
      "last_updated": "2026-02-10"
    },
    {
      "compound_1": "fish_oil",
      "compound_2": "tirzepatide",
      "interaction_type": "BLEEDING_RISK",
      "severity": "HIGH",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Monitor closely. 62 serious adverse events reported with this combination in FDA FAERS. Pharmacovigilance signal, not proof of causation. Discuss with prescriber.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/fish-oil-and-tirzepatide",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "folate",
      "compound_2": "semaglutide",
      "interaction_type": "ANTAGONISTIC",
      "severity": "HIGH",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Monitor closely. 198 serious adverse events reported with this combination in FDA FAERS. Pharmacovigilance signal, not proof of causation. Discuss with prescriber.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/folate-and-semaglutide",
      "last_updated": "2026-02-10"
    },
    {
      "compound_1": "folate",
      "compound_2": "tirzepatide",
      "interaction_type": "ANTAGONISTIC",
      "severity": "HIGH",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Monitor closely. 198 serious adverse events reported with this combination in FDA FAERS. Pharmacovigilance signal, not proof of causation. Discuss with prescriber.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/folate-and-tirzepatide",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "garcinia_cambogia",
      "compound_2": "semaglutide",
      "interaction_type": "PHARMACODYNAMIC_RISK",
      "severity": "MODERATE",
      "mechanism_category": "GASTROINTESTINAL",
      "clinical_note": "Both garcinia and GLP-1 agonists may cause GI side effects. Literature flags CFSAN adverse event reports for garcinia hepatotoxicity. Discuss with your prescriber or pharmacist.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/garcinia-cambogia-and-semaglutide",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "garcinia_cambogia",
      "compound_2": "tirzepatide",
      "interaction_type": "PHARMACODYNAMIC_RISK",
      "severity": "MODERATE",
      "mechanism_category": "GASTROINTESTINAL",
      "clinical_note": "Both garcinia and GLP-1 agonists may cause GI side effects. Literature flags CFSAN adverse event reports for garcinia hepatotoxicity. Discuss with your prescriber or pharmacist.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/garcinia-cambogia-and-tirzepatide",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "glucosamine",
      "compound_2": "semaglutide",
      "interaction_type": "PHARMACODYNAMIC_RISK",
      "severity": "MODERATE",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Monitor closely. 31 serious adverse events reported with this combination in FDA FAERS. Pharmacovigilance signal, not proof of causation. Discuss with prescriber.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/glucosamine-and-semaglutide",
      "last_updated": "2026-02-10"
    },
    {
      "compound_1": "glucosamine",
      "compound_2": "tirzepatide",
      "interaction_type": "PHARMACODYNAMIC_RISK",
      "severity": "MODERATE",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Monitor closely. 31 serious adverse events reported with this combination in FDA FAERS. Pharmacovigilance signal, not proof of causation. Discuss with prescriber.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/glucosamine-and-tirzepatide",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "iron",
      "compound_2": "semaglutide",
      "interaction_type": "PHARMACODYNAMIC_RISK",
      "severity": "HIGH",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Monitor closely. 135 serious adverse events reported with this combination in FDA FAERS. Pharmacovigilance signal, not proof of causation. Discuss with prescriber.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/iron-and-semaglutide",
      "last_updated": "2026-02-10"
    },
    {
      "compound_1": "iron",
      "compound_2": "tirzepatide",
      "interaction_type": "PHARMACODYNAMIC_RISK",
      "severity": "HIGH",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Monitor closely. 135 serious adverse events reported with this combination in FDA FAERS. Pharmacovigilance signal, not proof of causation. Discuss with prescriber.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/iron-and-tirzepatide",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "magnesium",
      "compound_2": "semaglutide",
      "interaction_type": "BLEEDING_RISK",
      "severity": "HIGH",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Monitor closely. 252 serious adverse events reported with this combination in FDA FAERS. Pharmacovigilance signal, not proof of causation. Discuss with prescriber.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/magnesium-and-semaglutide",
      "last_updated": "2026-02-10"
    },
    {
      "compound_1": "magnesium",
      "compound_2": "tirzepatide",
      "interaction_type": "BLEEDING_RISK",
      "severity": "HIGH",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Monitor closely. 252 serious adverse events reported with this combination in FDA FAERS. Pharmacovigilance signal, not proof of causation. Discuss with prescriber.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/magnesium-and-tirzepatide",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "melatonin",
      "compound_2": "semaglutide",
      "interaction_type": "BLEEDING_RISK",
      "severity": "HIGH",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Monitor closely. 65 serious adverse events reported with this combination in FDA FAERS. Pharmacovigilance signal, not proof of causation. Discuss with prescriber.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/melatonin-and-semaglutide",
      "last_updated": "2026-02-10"
    },
    {
      "compound_1": "melatonin",
      "compound_2": "tirzepatide",
      "interaction_type": "BLEEDING_RISK",
      "severity": "HIGH",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Monitor closely. 65 serious adverse events reported with this combination in FDA FAERS. Pharmacovigilance signal, not proof of causation. Discuss with prescriber.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/melatonin-and-tirzepatide",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "nac",
      "compound_2": "semaglutide",
      "interaction_type": "PHARMACODYNAMIC_RISK",
      "severity": "LOW",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Monitor closely. 4 serious adverse events reported with this combination in FDA FAERS. Pharmacovigilance signal, not proof of causation. Discuss with prescriber.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/nac-and-semaglutide",
      "last_updated": "2026-02-10"
    },
    {
      "compound_1": "nac",
      "compound_2": "tirzepatide",
      "interaction_type": "PHARMACODYNAMIC_RISK",
      "severity": "LOW",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Monitor closely. 4 serious adverse events reported with this combination in FDA FAERS. Pharmacovigilance signal, not proof of causation. Discuss with prescriber.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/nac-and-tirzepatide",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "probiotics",
      "compound_2": "semaglutide",
      "interaction_type": "SAFETY_CONCERN",
      "severity": "MODERATE",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Monitor closely. 27 serious adverse events reported with this combination in FDA FAERS. Pharmacovigilance signal, not proof of causation. Discuss with prescriber.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/probiotics-and-semaglutide",
      "last_updated": "2026-02-10"
    },
    {
      "compound_1": "probiotics",
      "compound_2": "tirzepatide",
      "interaction_type": "SAFETY_CONCERN",
      "severity": "MODERATE",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Monitor closely. 27 serious adverse events reported with this combination in FDA FAERS. Pharmacovigilance signal, not proof of causation. Discuss with prescriber.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/probiotics-and-tirzepatide",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "saw_palmetto",
      "compound_2": "semaglutide",
      "interaction_type": "ANTAGONISTIC",
      "severity": "LOW",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Monitor closely. 6 serious adverse events reported with this combination in FDA FAERS. Pharmacovigilance signal, not proof of causation. Discuss with prescriber.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/saw-palmetto-and-semaglutide",
      "last_updated": "2026-02-10"
    },
    {
      "compound_1": "saw_palmetto",
      "compound_2": "tirzepatide",
      "interaction_type": "ANTAGONISTIC",
      "severity": "LOW",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Monitor closely. 6 serious adverse events reported with this combination in FDA FAERS. Pharmacovigilance signal, not proof of causation. Discuss with prescriber.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/saw-palmetto-and-tirzepatide",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "semaglutide",
      "compound_2": "acetaminophen",
      "interaction_type": "ABSORPTION_INTERFERENCE",
      "severity": "MODERATE",
      "mechanism_category": "ABSORPTION",
      "clinical_note": "GLP-1 agonists delay gastric emptying, reducing acetaminophen absorption rate. Literature documents delayed Cmax by 1-3 hours. Clinical significance varies. Discuss with your prescriber or pharmacist.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/semaglutide-and-acetaminophen",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "semaglutide",
      "compound_2": "alpha_lipoic_acid",
      "interaction_type": "PHARMACODYNAMIC_RISK",
      "severity": "HIGH",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Both GLP-1 agonists and alpha-lipoic acid may lower blood glucose through different mechanisms. Combined use may increase hypoglycemia risk. Discuss with your prescriber or pharmacist.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/semaglutide-and-alpha-lipoic-acid",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "semaglutide",
      "compound_2": "bitter_melon",
      "interaction_type": "PHARMACODYNAMIC_RISK",
      "severity": "HIGH",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Bitter melon contains compounds with insulin-mimetic activity. Combined with GLP-1 agonists, literature flags increased hypoglycemia risk. Discuss with your prescriber or pharmacist.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/semaglutide-and-bitter-melon",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "semaglutide",
      "compound_2": "chromium",
      "interaction_type": "PHARMACODYNAMIC_RISK",
      "severity": "HIGH",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Both GLP-1 agonists and chromium may lower blood glucose. Combined use may increase hypoglycemia risk. Literature flags additive glucose-lowering effect. Monitor blood glucose and discuss with your prescriber or pharmacist.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/semaglutide-and-chromium",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "semaglutide",
      "compound_2": "cinnamon",
      "interaction_type": "PHARMACODYNAMIC_RISK",
      "severity": "HIGH",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Both GLP-1 agonists and cinnamon supplementation may lower blood glucose. Combined use may increase hypoglycemia risk. Discuss with your prescriber or pharmacist.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/semaglutide-and-cinnamon",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "semaglutide",
      "compound_2": "creatine",
      "interaction_type": "SAFETY_CONCERN",
      "severity": "MODERATE",
      "mechanism_category": "GASTROINTESTINAL",
      "clinical_note": "GLP-1 agonists commonly cause nausea and reduced fluid intake. Creatine increases hydration requirements. Combined use may compound dehydration risk and GI discomfort. Ensure adequate hydration and discuss with your prescriber or pharmacist.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/semaglutide-and-creatine",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "semaglutide",
      "compound_2": "fenugreek",
      "interaction_type": "PHARMACODYNAMIC_RISK",
      "severity": "HIGH",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Fenugreek has documented glucose-lowering properties. Combined with GLP-1 agonists, literature flags additive hypoglycemia risk. Discuss with your prescriber or pharmacist.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/semaglutide-and-fenugreek",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "semaglutide",
      "compound_2": "ginseng",
      "interaction_type": "PHARMACODYNAMIC_RISK",
      "severity": "HIGH",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Panax ginseng has documented glucose-lowering effects. Combined with GLP-1 agonists, additive hypoglycemia risk is flagged in literature. Discuss with your prescriber or pharmacist.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/semaglutide-and-ginseng",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "semaglutide",
      "compound_2": "gymnema_sylvestre",
      "interaction_type": "PHARMACODYNAMIC_RISK",
      "severity": "HIGH",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Gymnema sylvestre reduces intestinal glucose absorption and may stimulate insulin secretion. Combined with GLP-1 agonists, literature flags increased hypoglycemia risk. Discuss with your prescriber or pharmacist.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/semaglutide-and-gymnema-sylvestre",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "semaglutide",
      "compound_2": "levothyroxine",
      "interaction_type": "ABSORPTION_INTERFERENCE",
      "severity": "CRITICAL",
      "mechanism_category": "ABSORPTION",
      "clinical_note": "GLP-1 receptor agonists delay gastric emptying, potentially altering levothyroxine absorption timing. Levothyroxine has a narrow therapeutic index and is timing-sensitive. Literature flags altered thyroid hormone levels when co-administered. Discuss dosing schedule with your prescriber or pharmacist.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/semaglutide-and-levothyroxine",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "semaglutide",
      "compound_2": "nsaids",
      "interaction_type": "ABSORPTION_INTERFERENCE",
      "severity": "MODERATE",
      "mechanism_category": "ABSORPTION",
      "clinical_note": "GLP-1 agonists delay gastric emptying, potentially altering NSAID absorption timing and onset of effect. Literature flags delayed pain relief onset. Discuss with your prescriber or pharmacist.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/semaglutide-and-nsaids",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "semaglutide",
      "compound_2": "oral_contraceptives",
      "interaction_type": "ABSORPTION_INTERFERENCE",
      "severity": "HIGH",
      "mechanism_category": "ABSORPTION",
      "clinical_note": "GLP-1 agonists delay gastric emptying, potentially reducing oral contraceptive absorption. Literature flags possible reduced efficacy. Discuss backup contraception with your prescriber or pharmacist.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/semaglutide-and-oral-contraceptives",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "st_johns_wort",
      "compound_2": "semaglutide",
      "interaction_type": "ANTAGONISTIC",
      "severity": "MODERATE",
      "mechanism_category": null,
      "clinical_note": "Published literature flags interaction. Discuss with your prescriber or pharmacist.",
      "primary_pmid": "NCT05996874",
      "page_url": "https://truthstack.co/interactions/st-johns-wort-and-semaglutide",
      "last_updated": "2026-02-10"
    },
    {
      "compound_1": "st_johns_wort",
      "compound_2": "tirzepatide",
      "interaction_type": "PHARMACODYNAMIC_RISK",
      "severity": "LOW",
      "mechanism_category": "PHARMACOKINETIC",
      "clinical_note": "Tirzepatide is not significantly CYP-metabolized. Interaction risk with SJW likely low. Monitor glucose. Discuss with your prescriber or pharmacist.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/st-johns-wort-and-tirzepatide",
      "last_updated": "2026-02-15"
    },
    {
      "compound_1": "tirzepatide",
      "compound_2": "acetaminophen",
      "interaction_type": "ABSORPTION_INTERFERENCE",
      "severity": "MODERATE",
      "mechanism_category": "ABSORPTION",
      "clinical_note": "GLP-1 agonists delay gastric emptying, reducing acetaminophen absorption rate. Literature documents delayed Cmax by 1-3 hours. Clinical significance varies. Discuss with your prescriber or pharmacist.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/tirzepatide-and-acetaminophen",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "tirzepatide",
      "compound_2": "alpha_lipoic_acid",
      "interaction_type": "PHARMACODYNAMIC_RISK",
      "severity": "HIGH",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Both GLP-1 agonists and alpha-lipoic acid may lower blood glucose through different mechanisms. Combined use may increase hypoglycemia risk. Discuss with your prescriber or pharmacist.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/tirzepatide-and-alpha-lipoic-acid",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "tirzepatide",
      "compound_2": "bitter_melon",
      "interaction_type": "PHARMACODYNAMIC_RISK",
      "severity": "HIGH",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Bitter melon contains compounds with insulin-mimetic activity. Combined with GLP-1 agonists, literature flags increased hypoglycemia risk. Discuss with your prescriber or pharmacist.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/tirzepatide-and-bitter-melon",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "tirzepatide",
      "compound_2": "chromium",
      "interaction_type": "PHARMACODYNAMIC_RISK",
      "severity": "HIGH",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Both GLP-1 agonists and chromium may lower blood glucose. Combined use may increase hypoglycemia risk. Literature flags additive glucose-lowering effect. Monitor blood glucose and discuss with your prescriber or pharmacist.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/tirzepatide-and-chromium",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "tirzepatide",
      "compound_2": "cinnamon",
      "interaction_type": "PHARMACODYNAMIC_RISK",
      "severity": "HIGH",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Both GLP-1 agonists and cinnamon supplementation may lower blood glucose. Combined use may increase hypoglycemia risk. Discuss with your prescriber or pharmacist.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/tirzepatide-and-cinnamon",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "tirzepatide",
      "compound_2": "creatine",
      "interaction_type": "SAFETY_CONCERN",
      "severity": "MODERATE",
      "mechanism_category": "GASTROINTESTINAL",
      "clinical_note": "GLP-1 agonists commonly cause nausea and reduced fluid intake. Creatine increases hydration requirements. Combined use may compound dehydration risk and GI discomfort. Ensure adequate hydration and discuss with your prescriber or pharmacist.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/tirzepatide-and-creatine",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "tirzepatide",
      "compound_2": "fenugreek",
      "interaction_type": "PHARMACODYNAMIC_RISK",
      "severity": "HIGH",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Fenugreek has documented glucose-lowering properties. Combined with GLP-1 agonists, literature flags additive hypoglycemia risk. Discuss with your prescriber or pharmacist.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/tirzepatide-and-fenugreek",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "tirzepatide",
      "compound_2": "ginseng",
      "interaction_type": "PHARMACODYNAMIC_RISK",
      "severity": "HIGH",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Panax ginseng has documented glucose-lowering effects. Combined with GLP-1 agonists, additive hypoglycemia risk is flagged in literature. Discuss with your prescriber or pharmacist.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/tirzepatide-and-ginseng",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "tirzepatide",
      "compound_2": "gymnema_sylvestre",
      "interaction_type": "PHARMACODYNAMIC_RISK",
      "severity": "HIGH",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Gymnema sylvestre reduces intestinal glucose absorption and may stimulate insulin secretion. Combined with GLP-1 agonists, literature flags increased hypoglycemia risk. Discuss with your prescriber or pharmacist.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/tirzepatide-and-gymnema-sylvestre",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "tirzepatide",
      "compound_2": "levothyroxine",
      "interaction_type": "ABSORPTION_INTERFERENCE",
      "severity": "CRITICAL",
      "mechanism_category": "ABSORPTION",
      "clinical_note": "GLP-1 receptor agonists delay gastric emptying, potentially altering levothyroxine absorption timing. Levothyroxine has a narrow therapeutic index and is timing-sensitive. Literature flags altered thyroid hormone levels when co-administered. Discuss dosing schedule with your prescriber or pharmacist.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/tirzepatide-and-levothyroxine",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "tirzepatide",
      "compound_2": "nsaids",
      "interaction_type": "ABSORPTION_INTERFERENCE",
      "severity": "MODERATE",
      "mechanism_category": "ABSORPTION",
      "clinical_note": "GLP-1 agonists delay gastric emptying, potentially altering NSAID absorption timing and onset of effect. Literature flags delayed pain relief onset. Discuss with your prescriber or pharmacist.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/tirzepatide-and-nsaids",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "tirzepatide",
      "compound_2": "oral_contraceptives",
      "interaction_type": "ABSORPTION_INTERFERENCE",
      "severity": "HIGH",
      "mechanism_category": "ABSORPTION",
      "clinical_note": "GLP-1 agonists delay gastric emptying, potentially reducing oral contraceptive absorption. Literature flags possible reduced efficacy. Discuss backup contraception with your prescriber or pharmacist.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/tirzepatide-and-oral-contraceptives",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "turmeric",
      "compound_2": "semaglutide",
      "interaction_type": "SAFETY_CONCERN",
      "severity": "MODERATE",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Monitor closely. 14 serious adverse events reported with this combination in FDA FAERS. Pharmacovigilance signal, not proof of causation. Discuss with prescriber.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/turmeric-and-semaglutide",
      "last_updated": "2026-02-10"
    },
    {
      "compound_1": "turmeric",
      "compound_2": "tirzepatide",
      "interaction_type": "SAFETY_CONCERN",
      "severity": "MODERATE",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Monitor closely. 14 serious adverse events reported with this combination in FDA FAERS. Pharmacovigilance signal, not proof of causation. Discuss with prescriber.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/turmeric-and-tirzepatide",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "vitamin_b12",
      "compound_2": "semaglutide",
      "interaction_type": "SAFETY_CONCERN",
      "severity": "HIGH",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Monitor closely. 288 serious adverse events reported with this combination in FDA FAERS. Pharmacovigilance signal, not proof of causation. Discuss with prescriber.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/vitamin-b12-and-semaglutide",
      "last_updated": "2026-02-10"
    },
    {
      "compound_1": "vitamin_b12",
      "compound_2": "tirzepatide",
      "interaction_type": "SAFETY_CONCERN",
      "severity": "HIGH",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Monitor closely. 288 serious adverse events reported with this combination in FDA FAERS. Pharmacovigilance signal, not proof of causation. Discuss with prescriber.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/vitamin-b12-and-tirzepatide",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "vitamin_c",
      "compound_2": "semaglutide",
      "interaction_type": "BLEEDING_RISK",
      "severity": "MODERATE",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Monitor closely. 46 serious adverse events reported with this combination in FDA FAERS. Pharmacovigilance signal, not proof of causation. Discuss with prescriber.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/vitamin-c-and-semaglutide",
      "last_updated": "2026-02-10"
    },
    {
      "compound_1": "vitamin_c",
      "compound_2": "tirzepatide",
      "interaction_type": "BLEEDING_RISK",
      "severity": "MODERATE",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Monitor closely. 46 serious adverse events reported with this combination in FDA FAERS. Pharmacovigilance signal, not proof of causation. Discuss with prescriber.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/vitamin-c-and-tirzepatide",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "vitamin_d",
      "compound_2": "semaglutide",
      "interaction_type": "ANTAGONISTIC",
      "severity": "HIGH",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Monitor closely. 565 serious adverse events reported with this combination in FDA FAERS. Pharmacovigilance signal, not proof of causation. Discuss with prescriber.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/vitamin-d-and-semaglutide",
      "last_updated": "2026-02-10"
    },
    {
      "compound_1": "vitamin_d",
      "compound_2": "tirzepatide",
      "interaction_type": "ANTAGONISTIC",
      "severity": "HIGH",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Monitor closely. 565 serious adverse events reported with this combination in FDA FAERS. Pharmacovigilance signal, not proof of causation. Discuss with prescriber.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/vitamin-d-and-tirzepatide",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "vitamin_e",
      "compound_2": "semaglutide",
      "interaction_type": "BLEEDING_RISK",
      "severity": "MODERATE",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Monitor closely. 32 serious adverse events reported with this combination in FDA FAERS. Pharmacovigilance signal, not proof of causation. Discuss with prescriber.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/vitamin-e-and-semaglutide",
      "last_updated": "2026-02-10"
    },
    {
      "compound_1": "vitamin_e",
      "compound_2": "tirzepatide",
      "interaction_type": "BLEEDING_RISK",
      "severity": "MODERATE",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Monitor closely. 32 serious adverse events reported with this combination in FDA FAERS. Pharmacovigilance signal, not proof of causation. Discuss with prescriber.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/vitamin-e-and-tirzepatide",
      "last_updated": "2026-02-16"
    },
    {
      "compound_1": "zinc",
      "compound_2": "semaglutide",
      "interaction_type": "SAFETY_CONCERN",
      "severity": "MODERATE",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Monitor closely. 39 serious adverse events reported with this combination in FDA FAERS. Pharmacovigilance signal, not proof of causation. Discuss with prescriber.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/zinc-and-semaglutide",
      "last_updated": "2026-02-10"
    },
    {
      "compound_1": "zinc",
      "compound_2": "tirzepatide",
      "interaction_type": "SAFETY_CONCERN",
      "severity": "MODERATE",
      "mechanism_category": "PHARMACODYNAMIC",
      "clinical_note": "Monitor closely. 39 serious adverse events reported with this combination in FDA FAERS. Pharmacovigilance signal, not proof of causation. Discuss with prescriber.",
      "primary_pmid": null,
      "page_url": "https://truthstack.co/interactions/zinc-and-tirzepatide",
      "last_updated": "2026-02-16"
    }
  ]
}