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Clinical Guidelines and Research Currently, there are no specific clinical guidelines for using semaglutide in patients with high cortisol levels

doi: 10.1002/smrj.43

Arsova B, Hoja U, Wimmelbacher M, Greiner E, stn , Melzer M, Petersen K, Lein W, Bornke F (2010) Plastidial thioredoxin z interacts with two fructokinase-like proteins in a thiol-dependent manner: evidence for an essential role in chloroplast development in Arabidopsis and Nicotiana benthamiana

Although it's unclear if these effects would occur in humans, Rybelsus is contraindicated in individuals with a personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2