Officials in the U.K. have warned that increasingly popular weight-loss drugs like Ozempic may carry extra risks for people who need surgery.
The drugs slow the release of food and liquid from the stomach, making patients feel fuller for longer and helping many shed excess pounds. But this same mechanism may increase the risk of rare surgical complication called “aspiration,” where the contents of the stomach enter the lungs.
Patients normally fast before surgical procedures to reduce the chance of them inhaling any food or liquid from their gut while under anesthetic. But those on certain weight-loss and diabetes medications may still have leftovers in their system after a standard pre-surgical fast, according to an alert from the U.K.’s Medicines and Healthcare products Regulatory Agency.
Ozempic-Like Drugs And Slow Gastric Emptying
GLP-1 and dual GIP/GLP-1 receptor antagonists — the active ingredients in semaglutide (Ozempic and Wegovy) and tirzeparide (Zepbound and Mounjaro), respectively — can cause this slow gastric empyting. But people using the drugs may not be aware of the risks it may add to general anesthetic and deep sedation.
If content from the stomach gets into the lungs, it can cause severe complications including a lung infection known as aspiration pneumonia. This potentially deadly condition often requires antibiotics to treat.
The MHRA says it’s received a small number of reports of U.K. patients on the drugs inhaling stomach contents during surgery. In one case, a patient developed aspiration pneumonia.
The agency says patients should make sure their healthcare team know if they’re taking the drugs ahead of time, the regulator said. But they shouldn’t change or stop taking medications unless advised by a doctor.
Anesthetists and other healthcare professionals should assess this extra risk when managing surgical patients using a drug like Ozempic or Zepbound, particularly if they have other health issues that increase their chance of delayed gastric emptying, the MHRA says.
Is Ozempic Safe For Surgery?
Medical authorities in Europe and the U.S. have issued similar warnings as the popularity of Ozempic and other weight-loss drugs has risen. In the U.S. alone, at least 12% of adults have tried a GLP-1 RA, according to a recent JAMA Network poll.
Last summer, the European Medicines Agency released a set of guidelines for managing surgical patients on drugs including Wegovy, Mounjaro and Tirzepatide.
The EMA didn’t find a causal link between taking the drugs and inhaling stomach contents. But it did find a “biologically plausible risk” after reviewing available case reports and other literature.
Back in 2023, the American Society of Anesthesiologists recommended patients stop taking drugs like Ozempic and Trulicity altogether ahead of surgeries.
The Food and Drug Administration, which announced it was investigating the safety of weight-loss drugs around surgery last January, has been more conservative with its statements. In November, it updated labeling on drugs including Ozempic to reflect a small number of cases of stomach contents entering the lungs.
Labels now state that while there isn’t enough evidence to support recommendations like stopping the drugs before surgery, patients should make sure their healthcare teams know they’re using them in advance of any procedures.
The MHRA doesn’t advise a blanket halt on drugs like Ozempic or Mounjaro before surgeries either. Instead, it points to a recent consensus statement from several U.K. anesthetist groups that calls instead for individual risk assessments and risk-limitation measures for patients using the drugs.
