Reasons Why You Should Stop Taking Ozempic And Wegovy Before Surgery
Ozempic and Wegovy are medications medication that contains the active ingredient semaglutide. It belongs to a class of drugs called glucagon-like peptide-1 receptor agonists (GLP-1 RAs). Ozempic is primarily used to treat type 2 diabetes.
Their mechanism of action involves mimicking the effects of a naturally occurring hormone called glucagon-like peptide-1 (GLP-1) in the body. GLP-1 is produced by the intestines in response to food intake. It plays a crucial role in regulating blood sugar levels by stimulating insulin release from the pancreas, suppressing glucagon secretion (which helps lower blood sugar), and slowing down gastric emptying, which helps control the rate at which nutrients are absorbed into the bloodstream.
When injected, semaglutide acts as a GLP-1 receptor agonist. It binds to and activates GLP-1 receptors, stimulating insulin secretion, reducing glucagon release, and delaying stomach emptying. These actions collectively lead to lower blood sugar levels, improved glycemic control, reduced HbA1c levels (a measure of average blood sugar levels over time) and weight loss.
However, these trendy diabetes and weight-loss drugs could be dangerous for a patient undergoing anesthesia for an operation, according to a new warning from the American Society of Anesthesiologists.
Ozempic and Wegovy including other drugs of their class known as GLP-1 receptor agonists cause digestion to slow down, which decreases hunger and reduces how much people eat.
That food left in the stomach increases the risk you will vomit while under anesthesia, said ASA President Dr. Michael Champeau.
“We’ve had reports of people vomiting immediately preoperatively when there shouldn’t be any food in their stomach,” Champeau said. “As soon as we started hearing anecdotal reports and case reports, the mind immediately goes to how the drug works and what it does.”
The ASA is recommending that people on a GLP-1 agonist like Ozempic stop taking it prior to surgery.
If you take such a drug once a day, you should not take your daily dose the morning of surgery, Champeau said.
If you take the drug once a week, you should hold off on your dose until after surgery.
“If you take it every Sunday and you’re having surgery on a Wednesday, you can’t take it the Sunday before the surgery,” Champeau said. “You’ve got to stop it at least a week in advance, if you’re taking the once-a-week dose.”
There’s a reason patients are told to not eat the night before surgery, and it’s the same reason they need to hold off on Ozempic.
“When anesthesia was first discovered back in the 1840s, nobody knew about this and it happened a lot. You’d be putting someone to sleep with ether and they would vomit and they would suck it in their lungs and they would have terrible, terrible pneumonia or die,” Champeau said. “And so it became clear very early to us that this is a major complication of anesthesia and we have to find ways of reducing the likelihood of that as best we can.”
That’s why anesthesiologists are such sticklers for how long patients need to fast prior to surgery.
“We annoy people all the time. We annoy patients and we annoy surgeons, when a patient doesn’t follow the guidance that they’re given and they have a sandwich or toast or an egg or whatever on the morning of their surgery and then show up,” Champeau said. “We basically will not do the surgery at that point, and make people wait the prescribed amount of time.”
GLP-1 agonists like Ozempic were originally developed to treat people with diabetes. They mimic a hormone called GLP-1 that prompts the pancreas to produce more insulin after meals, according to Johns Hopkins Medicine.
But they also keep food in the stomach longer so patients feel full sooner when eating, and they suppress the appetite — the reasons why Ozempic has become renowned for aiding in weight loss.
Other GLP-1 agonists include dulaglutide (Trulicity), exenatide (Byetta), liraglutide (Victoza) and lixisenatide (Adlyxin), according to Johns Hopkins.
Patients can resume taking their GLP-1 agonist the next day after surgery, Champeau said.
Those taking the drugs to control diabetes might need to briefly switch to another drug, he added.
“They’re going to need to go to whichever doctor is managing their diabetes because they’re going to need to change to another antidiabetic therapy to keep their diabetes under control during those days that they’re not getting their Ozempic,” Champeau said.