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Other important adverse effects to be aware of include: Pancreatitis : If suspected (severe, persistent abdominal pain that may radiate to the back), stop taking Rybelsus immediately and seek urgent medical attention Gallbladder disease : Including gallstones and inflammation of the gallbladder (cholecystitis) Diabetic retinopathy complications : Particularly in patients with pre-existing retinopathy, especially those on insulin Dehydration and acute kidney injury : From persistent vomiting or diarrhoea Whilst there is ongoing surveillance regarding a potential link between GLP-1 receptor agonists and thyroid tumours, there is no established causal relationship in humans, though the medication carries precautionary labelling based on animal studies

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It is this last point—the ability to lower blood sugar—that creates the primary concern when combined with prescription treatments for diabetes or weight loss