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Others have case reports

Steroids induce insulin resistance by directly interfering with signaling cascades, mainly the GLUT4 transporter, within muscle cells, with the subsequent 30%-50% reduction in insulin-stimulated glucose uptake and a 70% reduction in insulin-stimulated glycogen synthesis[24,25]

Carretero Gmez J, ArvaloLorido JC, Gmez Huelgas R, Garca de Lucas D, Mateos Polo L, Varela Aguilar JM, et al

Contact your healthcare provider before taking ibuprofen with Rybelsus if you: Have a history of peptic ulcer disease, gastritis, or gastrointestinal bleeding Are experiencing significant nausea, vomiting, or abdominal pain from Rybelsus Have cardiovascular disease, heart failure, or uncontrolled hypertension Have chronic kidney disease or impaired renal function Are taking anticoagulants (such as warfarin, apixaban, or rivaroxaban) or antiplatelet agents (such as aspirin or clopidogrel) Are taking corticosteroids, SSRIs, or SNRIs, which increase gastrointestinal bleeding risk Are over 65 years of age, as NSAID-related complications are more common in older adults Require regular or long-term NSAID use Are pregnant or breastfeeding Are dehydrated or experiencing vomiting or diarrhoea Seek urgent medical attention if you develop: Black, tarry stools or blood in vomit (potential signs of gastrointestinal bleeding) Severe or persistent abdominal pain (if severe, stop taking Rybelsus immediately due to risk of pancreatitis) Unexplained bruising or bleeding Signs of allergic reaction (rash, swelling, difficulty breathing) Symptoms of dehydration (reduced urination, dizziness, confusion), particularly if experiencing vomiting or diarrhoea Your pharmacist can provide valuable guidance on over-the-counter pain relief options and potential interactions