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Common Contraindications and High-Risk Histories Based on FDA prescribing information for semaglutide products, clinicians commonly screen for: Personal or family history of medullary thyroid carcinoma , or related endocrine tumor syndromes Pregnancy or plans to become pregnant soon (timing and medical guidance matter) History of pancreatitis or severe unexplained abdominal pain episodes Gallbladder disease history, especially if symptoms recur Severe dehydration risk , especially if you already struggle with vomiting, diarrhea, or low fluid intake Situations That May Need Closer Monitoring Some people may still use semaglutide, but they may need extra follow-up