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FDA adds new warning to popular weight loss drugs

Injectable semaglutide Wegovy
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(WXYZ) — The Food and Drug Administration has updated labels for popular weight loss drugs like Ozempic and Wegovy.

A new warning highlights the risk of pulmonary aspiration during general anesthesia.

Pulmonary aspiration happens when food, liquid or stomach contents accidentally get into the lungs. This can be especially risky during anesthesia because when you’re unconscious, you can’t clear your lungs and the body’s defenses are slowed down.

It can lead to serious problems like inflammation, lung damage, aspiration pneumonia — which is an infection in the lungs — and even death.

Now, here’s why the warning was added for GLP-1 medications, which are used for both weight loss and diabetes. These drugs slow the movement of food through the digestive system, which helps people feel full longer. For those with diabetes, it also helps manage blood sugar. But when you undergo general anesthesia or deep sedation, it’s crucial to have an empty stomach.

Unfortunately, there have been cases where patients taking these medications inhaled liquid or food into their lungs during sedation because their stomachs were not fully empty. And this happened even after they followed fasting guidelines and didn’t eat for six to eight hours before the procedure.

So, the new label now warns that rare cases of pulmonary aspiration have been reported in patients taking GLP-1 medications during procedures requiring general anesthesia or deep sedation.

The drugs affected by the new warning include:

  • Semaglutide, with brand names Ozempic, Rybelsus, and Wegovy 
  • Liraglutide, which includes Saxenda and Victoza
  • Tirzepatide, which includes Mounjaro and Zepbound

When it comes to using GLP medications around surgery, the American Society of Anesthesiologists has guidelines to help reduce the aspiration risk. They recommend a 24-hour liquid-only diet before surgery, adjusting the anesthesia plan to reduce aspiration risk and using an ultrasound to check for any stomach contents in higher-risk patients.
From my experience, I advise my patients to stop these medications one week before surgery because I have seen food still in the stomach, and this is very serious. Aside from GLP-1 medications, aspiration happens in about 1 in 2,000 to 3,000 surgeries requiring sedation, according to the National Institutes of Health. Almost half of those cases lead to lung injury.

So, if you’re taking these medications, please let your doctor know if you are planning any surgery or any procedure that involves anesthesia or deep sedation.

THIS WEEK ON ‘THE DR. NANDI SHOW’

Dr. Partha Nandi, MD, sheds light on one of the deadliest cancers: pancreatic cancer. He’s joined by pancreatic surgeon Dr. David Kwon and Dr. Sheba Roy to discuss treatment options, while energy healer Elaine Grohman shares how energy healing can aid recovery. Nandi also highlights the symptoms and challenges of detecting this elusive cancer. Tune in this Sunday, NoV. 10 at 5 p.m.