GLP-1 receptor agonists, such as Ozempic and Wegovy, should be avoided before surgery, the American Society of Anesthesiologists (ASA) says.
Approved for the treatment of type 2 diabetes, glucagon-like peptide-1 (GLP-1) receptor agonists are a class of drugs sold under the brand names like Ozempic and Rybelsus. Some GLP-1 receptor agonists, such as Wegovy and Rybelsus, can also be used for weight loss, as they delay gastric (stomach) emptying, decreasing hunger and reducing how much people eat.
"While there is currently a lack of scientific data on how GLP-1 receptor agonists affect patients having surgery and interact with anesthesia, we’ve received anecdotal reports that the delay in stomach emptying could be associated with an increased risk of regurgitation and aspiration of food into the airways and lungs during general anesthesia and deep sedation," says ASA President Michael W. Champeau, M.D., FAAP, FASA.
Initial reports have found that patients who have experienced gastrointestinal side effects, such as nausea or vomiting while taking GLP-1 agonists, were more likely to have increased residual gastric contents.
The ASA recommends that patients taking a daily dose of GLP-1 agonists should not take the drug on the day of the procedure or surgery. Those on weekly dosing should consider pausing the drug a week prior. The recommendation applies regardless of the indication (type 2 diabetes or weight loss), dose, or type of procedure or surgery.
If GLP-1 agonists prescribed for diabetes management are held for longer than the dosing schedule, patients are advised to consult an endocrinologist for bridging the anti-diabetic therapy to avoid hyperglycemia.
Those experiencing gastrointestinal symptoms such as severe nausea, vomiting, or retching, as well as abdominal bloating or pain on the day of the procedure, should discuss the potential risks with the proceduralist or surgeon and consider delaying the procedure.
- The American Society of Anesthesiologists. American Society of Anesthesiologists Consensus-Based Guidance on Preoperative Management of Patients (Adults and Children) on Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists.
- The American Society of Anesthesiologists. Patients Taking Popular Medications for Diabetes and Weight Loss Should Stop Before Elective Surgery, ASA Suggests.