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Before starting Rybelsus , contact your GP if you have a history of: Pancreatitis (inflammation of the pancreas) GLP-1 receptor agonists have been associated with pancreatitis in rare cases [1] [5] Severe gastrointestinal disease , including gastroparesis or inflammatory bowel disease Diabetic retinopathy rapid improvements in glucose control may temporarily worsen this condition [1] [2] Thyroid disease while the UK product information notes rodent C-cell tumours with uncertain human relevance, discuss any thyroid conditions with your doctor [1] [4] During treatment , seek medical advice if you experience: Severe, persistent abdominal pain that may radiate to the back if pancreatitis is suspected, stop taking Rybelsus immediately and seek urgent medical assessment