From the Guidelines
Patients with a history of pancreatitis should not be given Ozempic (semaglutide) due to the increased risk of pancreatitis associated with GLP-1 receptor agonists. The medication carries a warning about the risk of pancreatitis because GLP-1 receptor agonists like Ozempic have been associated with acute pancreatitis, including fatal and non-fatal hemorrhagic or necrotizing pancreatitis 1. While not an absolute contraindication, the risk of pancreatitis is a significant concern, and alternative medications for diabetes or weight management that don't carry this risk profile should be considered first for these patients. Some key points to consider when evaluating the use of Ozempic in patients with a history of pancreatitis include:
- The potential benefits of Ozempic must be carefully weighed against the potential risks, including the risk of pancreatitis 1.
- Patients with a history of pancreatitis should be closely monitored for signs and symptoms of pancreatitis, including persistent severe abdominal pain that may radiate to the back, sometimes accompanied by vomiting 1.
- The medication should be promptly discontinued if pancreatitis is suspected.
- Alternative medications for diabetes or weight management that don't carry this risk profile should be considered first for these patients, such as metformin or SGLT2 inhibitors 1. It's also important to note that the mechanism behind this risk likely involves GLP-1 receptors in the pancreas and potential effects on pancreatic enzyme secretion and ductal pressure 1. Overall, the risk of pancreatitis associated with Ozempic is a significant concern, and alternative medications should be considered first for patients with a history of pancreatitis.
From the FDA Drug Label
OZEMPIC has not been studied in patients with a history of pancreatitis. Consider other antidiabetic therapies in patients with a history of pancreatitis [see Warnings and Precautions (5. 2)]. It is not known if OZEMPIC can be used in people who have had pancreatitis
Ozempic is not recommended for patients with a history of pancreatitis, as it has not been studied in this population and other antidiabetic therapies should be considered instead 2, 2, 2.
From the Research
Ozempic (Semaglutide) and Pancreatitis
- The use of Ozempic (semaglutide) in patients with a history of pancreatitis is a topic of interest, with some studies suggesting a potential link between semaglutide and acute pancreatitis 3, 4.
- However, a recent study found that semaglutide and tirzepatide, another GLP-1 receptor agonist, were associated with a reduced risk of recurrent acute pancreatitis in people with type 2 diabetes or obesity with a history of acute pancreatitis 5.
- The study found that semaglutide users had lower recurrence rates of acute pancreatitis compared to non-users, with a recurrence rate of 13.8% compared to 40.9% for non-users 5.
- Another study reported a case of acute pancreatitis in a patient taking semaglutide, highlighting the need for clinicians to be aware of the potential risk of acute pancreatitis with GLP-1 receptor agonist use 4.
- A review of the safety of semaglutide found that while it is effective in improving glycemic control and causing weight loss, it may increase the risk of biliary disease and pancreatic safety concerns, including pancreatitis and pancreatic cancer, cannot be ruled out due to low incidence of these conditions 6.
- Overall, the evidence suggests that semaglutide may be associated with a reduced risk of recurrent acute pancreatitis in some patients, but clinicians should be aware of the potential risk of acute pancreatitis with GLP-1 receptor agonist use, particularly in patients with a history of pancreatitis 5, 3, 4, 6.
Key Considerations
- Patients with a history of pancreatitis should be closely monitored when taking semaglutide, and clinicians should be aware of the potential risk of acute pancreatitis 3, 4.
- The benefits and risks of semaglutide should be carefully weighed in patients with a history of pancreatitis, and alternative treatments may be considered if necessary 6.
- Further studies are needed to fully understand the relationship between semaglutide and pancreatitis, and to determine the best course of treatment for patients with a history of pancreatitis 5, 6.