In this photo illustration, a box of the diabetes drug Ozempic sits on the counter of a pharmacy on April 17, 2023 in Los Angeles, California.
Mario Tama | Getty Images
People on diabetes and weight loss medications as Novo NordiskOzempic and the Wegos should stop taking them than to have elective surgery reduce the risk of serious health complications, a prominent group of doctors has said.
The guidance aims to help doctors manage patients taking the medication who are scheduled to undergo elective surgery, which are non-emergency procedures such as kidney stone removal, joint replacement and cosmetic surgery.
The ASA said the guidance reflected concerns related to delayed gastric emptying, or when food sits in the stomach longer than usual. This is one of the effects of diabetes and weight loss drugs that mimic a hormone produced in the gut called GLP-1 and ultimately suppress appetite.
Delayed gastric emptying can cause patients undergoing anesthesia to experience nausea, vomiting and aspiration, which is when a person accidentally breathes food into the lungs instead of swallowing it, according to the ASA.
That is why they are usually patients required fasting before anesthesia for procedures.
The ASA has received anecdotal reports from across the U.S. that patients taking drugs during general anesthesia and deep sedation may be at increased risk of these “serious” complications, group president Dr. Michael Champeau.
Ozempic and Wego are already associated with stomach problems such as diarrhea and constipation. However, Champeau acknowledged that there is still a lack of scientific data on exactly how anesthesia interacts with these drugs, also known as GLP-1.
Every day, probably 60,000 people nationwide, they receive general anesthesia or drugs given to relieve pain during operations and other procedures.
It’s unclear how many people take GLP-1 drugs on a daily basis, but their popularity has skyrocketed over the past year for weight loss “miracles.” Now Ozempic and Wego’s Novo Nordisk companies are plagued by nationwide shortages. It also faces increasing competition from similar treatments Eli Lillyis Mounjaro.
According to ASA guidance, people taking GLP-1 medications daily should skip treatment on the day of planned surgery.
Those taking GLP-1 weekly should stop the treatment a week before scheduled surgery, the group said.
Before surgery, physicians should consider consulting with an endocrinologist regarding guidelines for patients taking GLP-1 for diabetes.
The group also said doctors should consider postponing a patient’s procedure if the person experiences nausea, vomiting or abdominal bloating or pain on the day of the scheduled procedure.
If a patient has none of these symptoms but has not stopped using GLP-1 before surgery, doctors should consider using an ultrasound to check if they have a “full stomach”.