As GLP-1 drugs containing semaglutide continue to grow in popularity, Reddit users have been discussing its dangers and the potential for overdose. An expert says it’s a valid concern.
Semaglutide is the active ingredient in diabetes and weight loss drugs, including Ozempic, Wegovy, and Rybelsus. These drugs are GLP-1 agonists that help to lower blood sugar, and they are currently all the rage.
But while more and more patients are being prescribed semaglutide, serious side effects and the potential for overdose are legitimate risks many are concerned about — particularly on the r/Health subreddit.
After one Reddit user shared a link to a Scientific American article about overdosing on semaglutide drugs, users began sharing their own experiences and points of view — debating whether overdose with these drugs is a real risk and, if so, how it can be avoided.
Cases of semaglutide overdose
The risk for overdose mostly lies in dosing errors, which can occur when individuals receive their medication from compounding pharmacies rather than directly from the company as a result of shortages. While vials from the company Novo Nordisk come with preportioned doses that can be immediately injected, individuals are often required to portion their own doses prior to injection when receiving the drug from a compounding pharmacy. This can lead to mistakes.
And according to some Reddit users, the impacts of taking too high a dose can be extremely serious — potentially causing severe gastrointestinal issues that may require hospitalization.
“We had 19 y/o who perforated her esophagus from vomiting for 4 days after taking a high dose,” wrote u/ Sufficient-Cover5956 of one overdose instance.
Another user shared what happened to his father after stopping Ozempic for four months and then being told by his doctor that he could go right back to taking the same dose.
“He couldn't even keep water down for 2 days and after a week of barely being able to eat I had to get him to emergency where his blood pressure was 60,” u/ fddfgs wrote.
The discussion comes after the United States Food and Drug Administration (FDA) recently shared a health alert with healthcare providers, pharmacies, and patients about the dangers of dosing errors and the risk of overdose.
Last year, from January through November 2023, almost 3,000 calls to poison control centers in the U.S. were related to semaglutide.
Unfamiliarity with withdrawing medication from a vial into a syringe, coupled with confusion between different units of measurement, is likely to have contributed to dosing errors, the FDA said.
“FDA has received reports of adverse events, some requiring hospitalization, that may be related to overdoses due to dosing errors associated with compounded semaglutide injectable products,” the FDA said. “Dosing errors have resulted from patients measuring and self-administering incorrect doses of the drug and health care providers miscalculating doses of the drug.”
The adverse effects seen in these cases include severe nausea, severe vomiting, and severe hypoglycemia (low blood sugar levels).
A focus on the benefits
While many users in the Reddit discussion highlighted the potential dangers of taking the wrong dose, some also focused on the benefits they’ve received since taking GLP-1 medications — especially those beyond just weight loss and diabetes management.
“My favourite side effects are that it's completely got rid of my ibs, and my migraines are down from 1 a week to 1 a month,” wrote u/FlowerMonkeyButt.
User u/LiteratureLoud3993 meanwhile said the medication helps with their alcohol cravings.
Some studies have shown that GLP-1 drugs have the potential to treat alcohol use disorder, with some experts suggesting that they have the potential to be used as an anti-addiction drug.
Reddit users also claimed the drug helps with inflammation and pain from chronic diseases.
Side effects worsened without lifestyle changes
Despite these positive effects, semaglutide overdose is entirely possible and can be serious if it occurs, according to Gowri Reddy Rocco, M.D., a double board-certified regenerative health physician and a hormone expert.
Even without overdosing, Rocco says the negative side effects can be severe — especially if the medication isn’t accompanied by an improved diet and regular exercise as advised.
This point was mentioned by one Reddit user: “It even has harsh side effects when you don't overdose,” wrote u/Ezra_lurking. “I'm very thankful for it, it makes my diabetes easily manageable, but it can be very hard on the body.”
The most common side effects associated with semaglutide are typically gastrointestinal-related, including nausea, vomiting, constipation, bloating, acid reflux, abdominal discomfort, and diarrhea.
Other possible side effects, according to Rocco, include depression, kidney disease, headaches, darkened urine, increased heart rate, skin rash, trouble sleeping, weakness, nightmares, pancreatitis, thyroid problems, and cancer.
“Prescribing too high of a prescription, not taking it with a healthy diet and exercise modifications, taking it with other prescriptions, or taking it with alcohol or tobacco can cause side effects,” Rocco tells Healthnews.
How to avoid overdose and side effects
To help prevent adverse events, one Reddit user suggested that the FDA restrict these drugs to people who have type 2 diabetes or a BMI over 30 and that individuals should stop the drug when their BMI reaches 25.
Rocco agrees with this statement, particularly as a result of a recently released study that suggests it may increase the risk of suicidality. The study, published by JAMA Network Open, showed that semaglutide was linked with a 45 percent greater likelihood of suicidal ideation when compared to other drugs.
“It is critical to have follow-up care and be aware of this possible side effect,” Rocco says.
“Great caution needs to be taken to limit this drug to dosing, treating only DM2 patients, and close follow-up for side effects.”
When it comes to ensuring proper dosing for those receiving the drug through a compounding pharmacy, the FDA encourages patients to talk with their health care provider or pharmacy about how to measure and administer the intended dose of compounded semaglutide to prevent overdose.
Because many of the patients who overdosed lacked experience with self-injections, getting all your questions answered by a medical professional before attempting to give yourself the correct dose can help prevent a negative outcome.
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