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Topline
European medical officials advised patients taking GLP-1 drugs for weight loss and diabetes who will be sedated for an upcoming surgery to alert their doctors about their medication use to avoid the risk of a rare breathing complication called aspiration, a link that several other medical organizations have investigated in the past.
Patient view of medical surgeons and physicians placing a patient under general anesthesia
Key facts
The European Medicines Agency has released a new medicine recommendations Friday said patients taking GLP-1 drugs such as Ozempic, Wegovy, Mounjaro and Zepbound should inform their doctors before surgery to minimize the risk of adverse respiratory events that may be caused by the drugs.
GLP-1s are medications designed to control type 2 diabetes and obesity by lowering blood sugar levels and A1C, interacting with the hunger part of the brain to suppress appetite and slowing the process of emptying food from the stomach, making patients feel full longer.
Due to the delay in stomach emptying, food can remain in the stomach even if a patient has fasted the night before surgery, which can lead to rare breathing complications called aspiration and aspiration pneumonia, according to the EMA.
Although the agency said it could not find a causal link between GLP-1s and aspiration, it found a “biologically plausible risk” after reviewing available evidence such as case reports, scientific articles and clinical and non-clinical data to support its decision.
The EMA said it would update the medicines’ product information with a warning that patients should tell doctors about their GLP-1 drug use before undergoing surgery that requires anesthesia or deep sedation.
What is aspiration and aspiration pneumonia?
Aspiration happens when substances such as food or liquid accidentally enter a person’s airways and lungs, according to the Washington State Department of Social and Health Services. This can then lead to: aspiration pneumonia– known as the ‘silent killer’ – which is a serious infection of the lungs. Aspiration pneumonia does not always have many symptoms and can be fatal if left untreated. People who eat quickly, have had a general anesthetic, have difficulty swallowing or coughing, are 65 years or older, have a weakened immune system, use tube feeding, have had a stroke, drink a lot of alcohol and cannot chew properly are most affected . are at risk for aspiration and aspiration pneumonia. Symptoms include shortness of breath, wheezing, coughing up blood or pus, chest pain, bad breath, extreme fatigue, tiredness while eating, a feeling of choking, pain while swallowing, chronic chest congestion, and fever after eating .
Important background
The EMA’s decision will come afterwards asked four GLP-1 drug manufacturers, including Novo Nordisk and Eli Lilly in 2023 for more information on the potential for sedation complications. Aspiration occurs in one of each 2,000 to 3,000 patients requiring sedation for surgery, and approximately half of these patients develop a related lung injury. The Food and Drug Administration in January began an investigation into whether GLP-1s cause side effects such as aspiration and hair loss, CBS News reports. Also the American Society of Anesthesiologists advised patients in 2023 who take the weekly injections to stop taking GLP-1 drugs at least one week before surgery due to an “increased risk of regurgitation and aspiration of food into the airways and lungs during general anesthesia and deep sedation.” Canadian researchers called that patients should stop taking GLP-1s at least three weeks before undergoing anesthesia due to the risk of aspiration.
Large number
12%. That’s how many American adults have used GLP-1 drugs, according to a May article report by the nonprofit health policy organization KFF.
Read further
What to Know About Ozempic: The Diabetes Drug Becomes a Viral Weight-Loss Hit (Elon Musk Taps It) and Creates a Shortage (Forbes)
Diabetes Drug Mounjaro Expected to Be Approved Soon for Weight Loss: What You Need to Know and How It Compares to Similar Drugs (Forbes)