GLP-1 labels carry pulmonary aspiration warning

Editor's Note

The US Food and Drug Administration (FDA) has updated the labels of all treatments containing GLP-1 receptor agonists with a warning about warning about pulmonary aspiration during general anesthesia or deep sedation.

Drugs and brand names listed in a November 8 report on the development from MedPage Today include semaglutide (Ozempic, Wegovy, Rybelsus), tirzepatide (Mounjaro, Zepbound), dulaglutide (Trulicity), exenatide (Byetta, Bydureon BCise), liraglutide (Victoza, Saxenda), and lixisenatide (Adlyxin).

Used to treat weight loss and diabetes, the drugs work by delaying gastric emptying. This increases the risk of aspiration and regurgitation under anesthesia. According to MedPage, the new language points out rare reports of “residual gastric contents despite reported adherence to preoperative fasting recommendations" and warns patients to tell healthcare providers about planned procedures. However, the labels do not offer recommendations for reducing the risk.

The full report also details how “the idea of a pre-surgical GLP-1 hiatus has divided anesthesiologists,” as well as the latest guidelines on the drugs from the American Society of Anesthesiologists (ASA) and other organizations.