The U.S. Food and Drug Administration (FDA) has updated the safety labels for GLP-1 receptor agonists, including popular drugs like Ozempic and Wegovy, to include a warning about the potential risk of pulmonary aspiration during anesthesia. This action follows similar recommendations issued by the European Medicines Agency (EMA) earlier this year.
The FDA's warning, added on November 1, applies to a range of GLP-1 receptor agonists, including Ozempic, Wegovy, Rybelsus, Saxenda, Victoza, Mounjaro, and Zepbound. These medications, prescribed for both diabetes treatment and weight management, are known to slow gastric emptying. This can result in the presence of gastric fluids in the stomach even after patients have followed standard pre-anesthesia fasting guidelines.
Understanding the Aspiration Risk
Pulmonary aspiration, the inhalation of gastric contents into the lungs, is a rare but serious complication during anesthesia. The FDA's updated label indicates that while rare, cases of pulmonary aspiration have been reported in patients taking GLP-1 receptor agonists. The agency is currently unsure whether adjusting pre-anesthesia fasting periods or temporarily discontinuing GLP-1 use before surgery could mitigate this risk. The FDA emphasizes that patients should inform their healthcare providers about their use of GLP-1 medications before undergoing any surgical procedures.
Expert Perspectives and Recommendations
Dr. Angela Fitch, an obesity specialist and co-founder of knownwell, notes that medical providers have been aware of this potential risk for several years. She suggests that while the majority of patients on GLP-1s are unlikely to experience issues, the slowed stomach emptying could pose a problem for some. Dr. Fitch recommends that patients continue taking their medication but extend their fasting period before surgery to allow for more complete gastric emptying.
"The issue is not so much that the medication increases the risk of aspiration itself," Dr. Fitch explained. "It's about giving your stomach enough time to empty."
Context of GLP-1 Receptor Agonist Use
GLP-1 receptor agonists have gained significant attention, particularly after the FDA approved Wegovy for weight loss in 2021. According to a May 2024 KFF Health News poll, approximately 12% of U.S. adults have used a GLP-1 medication for weight loss, diabetes management, or other conditions. As usage increases, understanding and managing potential risks associated with these drugs becomes increasingly important.
Moving Forward
While the updated FDA warning may increase patient awareness, Dr. Fitch emphasizes the need for further research to fully understand the effects of GLP-1s on patients undergoing surgery. The FDA and EMA recommendations underscore the importance of communication between patients and healthcare providers regarding GLP-1 use in the context of surgical procedures and anesthesia.
