Doctors are warning popular drugs taken for weight loss, such as Ozempic and Wegovy, may include the risk of life-threatening complications under anesthesia.
Patients who take drugs like Wegovy or Ozempic for weight loss may face life-threatening complications if they need surgery or other procedures that require empty stomachs for anesthesia.
This summer’s guidance to halt the medication for up to a week may not go far enough, officials said. Some anesthesiologists in the United States and Canada say they’ve seen growing numbers of patients on the weight-loss drugs who inhaled food and liquid into their lungs while sedated because their stomachs were still full—even after following standard instructions to stop eating for six to eight hours in advance.
The drugs can slow digestion so much that it puts patients at increased risk for the problem, called pulmonary aspiration, which can cause dangerous lung damage, infections, and even death, said Dr. Ion Hobai, an anesthesiologist at Massachusetts General Hospital in Boston.
“This is such a serious sort of potential complication that everybody who takes this drug should know about it,” Mr. Hobai, who was among the first to flag the issue, told The Associated Press this week.
Mr. Hobai suggested that individuals taking the drugs first tell their doctors before sedation and discuss the risk profile. “If you’re taking this drug and you need an operation, you will need to have some extra precautions,” he said.
It’s not clear how many patients taking the anti-obesity drugs may be affected by the issue. But because the consequences can be so dire, Mr. Hobai and a group of colleagues decided to speak out. Writing in the Canadian Journal of Anesthesia in mid-July, they called for the drug to be stopped for even longer—about three weeks before sedation.
That accounts for how long semaglutide, the active medication in Ozempic and Wegovy, remains in the body, said Dr. Philip Jones, a Mayo Clinic anesthesiologist who is also deputy editor-in-chief of the journal. “When 90 percent of it is gone, which is after three weeks, hopefully everything should go back to normal,” Mr. Jones said.
Several weeks ago, the American Society of Anesthesiologists (ASA) said that people who take GLP-1 agonists like Wegovy or Ozempic every day should stop taking the drugs on the day of their surgery.
That guidance was disseminated after “many reports from medical literature and anesthesia leaders about people who fasted but still vomited either going to sleep or waking up from anesthesia,” said Dr. Ronald L. Harter, the incoming president of the ASA and a professor of anesthesiology at The Ohio State University Wexner Medical Center.
“This was very concerning and something we needed to address and communicate to the public like we are doing right now,” Mr. Harter told ABC.
Anesthesiologists have long discouraged patients from drinking or eating before surgery to ensure the stomach is empty to reduce the chance of vomiting during the procedure.
“This is really a fairly unique situation where you have a relatively new class of drugs that are very, very quickly being taken up by and are being used by a fairly significant portion of the population,” Mr. Harter said. “One of the potential side effects of these medications is to delay gastric emptying, which has a unique risk or potential for aspiration for patients undergoing anesthesia. It was a combination of all those factors that really prompted us to give guidance, really to our anesthesiologist and to our patients who are on these medications.”
The group stated that if the patient is having symptoms such as vomiting, bloating, abdominal pain, or nausea, doctors should consider delaying the surgical procedure.
Several weeks ago, the European Medicines Agency (EMA) said it was investigating a connection between Ozempic and Wegovy and suicidal thoughts. About 150 reports of possible cases of self-injury among people taking semaglutide GLP-1 agonists were flagged.
Sales of semaglutide products—particularly Ozempic—have soared in the past few years after the drug was shown to spur fast and significant weight loss. The drugs manufactured by Novo Nordisk include the brands Ozempic and Rybelsus, which are approved to treat diabetes, and Wegovy, which is approved by the FDA to treat obesity.
Earlier this year, Novo Nordisk promised to boost its supply of Wegovy. However, in the company’s first-quarter earnings report, the firm said that it would “temporarily” reduce U.S. supply.
Demand for the medications has outstripped supply. As of May, Ozempic and Wegovy remain on the FDA’s list of drug shortages. When drugs are in short supply, compounding pharmacies are permitted to produce versions of those medications.
The U.S. Food and Drug Administration (FDA) in 2014 approved semaglutide for weight loss among overweight or obese individuals with high blood pressure, Type 2 diabetes, and high cholesterol.