From the Guidelines
The patient can typically resume Wegovy at the 1 mg dose after a one-month break for endoscopy, but should consult their healthcare provider first, considering the potential increased risk of pulmonary aspiration and retained gastric contents associated with GLP-1 receptor agonist use. To resume:
- Contact the prescribing doctor before restarting.
- If approved, restart with the 1 mg dose as previously prescribed.
- Continue the regular weekly injection schedule. Additional considerations:
- Monitor for any side effects when restarting, especially gastrointestinal symptoms, as GLP-1 receptor agonists like semaglutide have been associated with an increased risk of pulmonary aspiration and retained gastric contents, as reported in studies such as 1.
- If significant side effects occur, the doctor may recommend temporarily reducing the dose to 0.5 mg and then titrating back up to 1 mg.
- Maintain healthy diet and exercise habits during the break to help minimize potential weight regain, as suggested by obesity management guidelines 1. Reasoning: Wegovy (semaglutide) has a long half-life, which allows for some flexibility in dosing, but the potential risks associated with its use, particularly in the peri-operative period, should be carefully considered, as highlighted in recent studies 1. A one-month break is not likely to significantly alter the patient's tolerance to the medication, but individual responses can vary, which is why consulting the healthcare provider is important to ensure safe and effective resumption of treatment. The patient's healthcare provider should be aware of the latest guidelines and evidence on the use of GLP-1 receptor agonists, including the potential benefits and risks, as discussed in studies such as 1 and 1.
From the Research
Resuming Wegovy (Semaglutide) After Discontinuation
- There is no direct evidence in the provided studies regarding the resumption of Wegovy (semaglutide) 1 milligram after a one-month discontinuation for an endoscopy 2, 3, 4, 5, 6.
- However, study 6 discusses switching between GLP-1 receptor agonists, including semaglutide, and provides guidance on how to manage this in clinical practice.
- The study suggests that when switching between GLP-1RAs, an individualized approach is recommended, considering factors such as treatment duration, dose, and patient experience with the previous GLP-1RA.
- It also emphasizes the importance of slow up-titration and advising patients to reduce food portion sizes and fat intake to minimize transient gastrointestinal adverse effects that may occur when switching to another GLP-1RA.
- Study 5 discusses the use of midazolam for patients undergoing upper gastrointestinal endoscopy, but does not provide information on the resumption of semaglutide after discontinuation.
Considerations for Resuming Semaglutide
- The decision to resume semaglutide after discontinuation should be made on a case-by-case basis, taking into account the individual patient's needs and medical history.
- It is essential to consider the patient's response to semaglutide before discontinuation, as well as any potential changes in their medical condition or treatment regimen during the discontinuation period.
- As with any medication, patients should be closely monitored for adverse effects and efficacy after resuming semaglutide.