In this photo illustration, a box of the diabetes drug Ozempic sits on a pharmacy counter on April 17, 2023, in Los Angeles, California.
Mario Tama | Getty Images
People with diabetes and weight loss medications, such as Novo Nordisk‘s Ozempic and Wegovy should stop taking them for having elective surgery to reduce the risk of serious health complications, a prominent group of doctors said.
The American Society of Anaesthesiologistsan organization of more than 53,000 physicians who practice anesthesiology interim guidance with that suggestion late Thursday.
The guideline is designed to help doctors treat patients on medicines who need to undergo elective surgery, which are non-emergency procedures such as kidney stone removal, joint replacement and cosmetic surgery.
The ASA said the guidelines reflect concerns related to delayed gastric emptying, or when food sits in the stomach longer than normal. That’s an effect of diabetes and weight loss medications, which mimic a hormone produced in the gut called GLP-1, ultimately suppressing a person’s appetite.
Delayed gastric emptying can cause patients undergoing anesthesia to experience nausea, vomiting and aspiration, which is when a person accidentally inhales food into their lungs instead of swallowing it, according to the ASA.
That’s why patients are typical needed to fast before undergoing anesthesia for procedures.
The ASA has received anecdotal reports from across the U.S. that patients taking the drugs during general anesthesia and deep sedation may be at increased risk for those “serious” complications, said the group’s president, Dr. Michael Champeau, in the directive.
Ozempic and Wegovy are already associated with side effects such as diarrhea and constipation.
But Champeau acknowledged that there is still a lack of scientific data on exactly how anesthesia interacts with those drugs, which are also known as GLP-1s.
Every day approx 60,000 people the entire country is receiving general anesthesia or medication administered for pain relief during surgeries and other procedures.
It’s unclear how many people take GLP-1 drugs every day, but their popularity has skyrocketed in the past year because they are “miracles” for weight loss. Now Novo Nordisk’s Ozempic and Wegovy are plagued by nationwide shortages. They also face increasing competition from similar treatments such as Eli Lilly‘s Munjaro.
Under the guidance of the ASA, people taking daily GLP-1 drugs must skip treatment on the day of elective surgery.
Those taking GLP-1s weekly should discontinue treatment one week before scheduled surgery, the group said.
Prior to surgery, doctors should consider consulting an endocrinologist for advice on patients taking GLP-1s for diabetes.
The group also said doctors should consider delaying a patient’s procedure if that person experiences nausea, vomiting or bloating or pain on the day of their scheduled procedure.
If a patient has none of these symptoms but has not stopped taking GLP-1s before surgery, doctors should consider using ultrasound to check if they have a “full stomach.”