Popular weight loss drug gets new warning

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It’s typical for surgery patients to be told not to eat or drink anything for a period prior to operation in order to prevent vomiting and subsequent health complications during their procedure.

However, that period may not be long enough to ensure the stomach is empty if an individual is taking certain medications for diabetes and/or weight loss that slow gastric emptying. That’s according to a recent advisory issued by the American Society of Anesthesiologists (ASA).

In recent weeks, the ASA came out with new guidance that suggests withholding use of medications like Wegovy and Ozempic prior to surgery to reduce the risk of complications associated with anesthesia.

“Because of the delayed gastric emptying, we’re finding more and more people are arriving for surgery with basically full stomachs, and that’s the one thing we don’t want when we’re doing an elective operation,” said Jodie Emerson, president elect of the Michigan Association of Nurse Anesthetists and a practicing nurse anesthetist in Alma.

Wegovy and Ozempic are brand names for a drug called semaglutide that helps control blood sugar levels in adults with diabetes. They and other glucagon-like peptide-1 (GLP-1) receptor agonists like Trulicity can delay stomach emptying, decrease hunger and reduce how much people eat.

Emerson said the problem comes if a patient doesn’t disclose to their nurse and/or surgeon that they’re taking one of these drugs. Without that knowledge, they may begin anesthesia before the stomach has been cleared, which can increase the risk of regurgitation and aspiration of food into the airways and lungs before or during surgery.

If food from the stomach comes back up the esophagus and into the back of your throat, it can make its way into your lungs and potentially lead to pneumonia.

ASA President Dr. Michael Champeau said the association has received anecdotal reports that the delay in stomach emptying could be associated with this increased risk. More research is needed on how these drugs interact with anesthesia.

“These complications can be serious, so we are providing guidance on when GLP-1 agonists should be stopped in advance of an elective procedure,” Champeau said.

Patients who take a GLP-1 agonist daily should not take their dose the day of their procedure or surgery. Those who take it weekly should not take their dose the week prior to the procedure.

If they are on these medications, their care team can take an ultrasound to see the contents of their stomach before surgery and take precautions.

“We’re putting more of a big push on making the public aware that they need to disclose medications they’re taking, as well as supplements they’re taking,” Emerson said. “Honesty is the best policy.”

Semaglutide which was first developed to help control blood sugar levels in adults with diabetes. However, it proved beneficial for weight loss in non-diabetics as well.

Wegovy gained U.S. Food and Drug Administration approval in June 2021. Within a year, success stories of weight loss from users of the weekly shots sparked an increase in popularity.

You should also talk to your doctor to see if another medication is recommended leading up to surgery to help control your condition.

The ASA said patients should consider delaying their procedure if they experience gastrointestinal symptoms the day of their surgery, such as severe nausea/vomiting/retching, abdominal bloating or abdominal pain.

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