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Neonatal blood concentrations of metformin have been found to equal or surpass half of maternal levels, raising concerns about the potential impact of elevated metformin levels on neonatal glucose metabolism and the development of hypoglycemia in newborns

When to contact your GP or diabetes specialist nurse: If you've been taking expired Rybelsus and notice worsening blood glucose control If you experience unexplained symptoms such as persistent thirst, increased urination, or fatigue If you're unable to obtain a fresh supply of your medication For advice on alternative diabetes management strategies if Rybelsus is temporarily unavailable Seek urgent medical advice (call NHS 111) or emergency care (999) if you experience: Severe dehydration (extreme thirst, dry mouth, little or no urination) Confusion or drowsiness Rapid breathing Severe abdominal pain or persistent vomiting Very high blood glucose levels that don't respond to usual treatment These could be signs of severe hyperglycaemia or hyperosmolar hyperglycaemic state (HHS), which requires immediate medical attention

Medical Procedures and Semaglutide Timing Considerations If you're scheduled for surgery or a procedure requiring fasting or medication adjustments, your provider may recommend stopping semaglutide three to five weeks beforehand

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