From the Guidelines
Management of bruising and impaired wound healing associated with Zepbound (glucagon-like peptide-1 receptor agonist) therapy should prioritize meticulous wound care, including sharp debridement and basic wound dressings, as well as consideration of adjunctive therapies such as topical oxygen therapy or hyperbaric oxygen therapy in specific cases, as supported by recent guidelines 1. When managing bruising and impaired wound healing in patients on Zepbound therapy, it is essential to consider the potential effects of GLP-1 receptor agonists on wound healing, including reduced inflammation and angiogenesis.
- For minor bruising, applying cold compresses for 10-15 minutes several times daily within the first 24-48 hours can help, followed by warm compresses thereafter to promote healing.
- Topical arnica gel or cream may reduce bruising appearance when applied 2-3 times daily.
- For wound healing concerns, keeping the area clean with mild soap and water, applying appropriate dressings, and monitoring for signs of infection are crucial.
- In cases of significant bruising or severely impaired wound healing, temporarily reducing the Zepbound dose or pausing treatment may be necessary, particularly around surgical procedures.
- Nutritional support, including adequate protein intake (1.2-2.0 g/kg/day) and vitamin C (500-1000 mg daily), can also support tissue repair. According to the guidelines on interventions to enhance healing of foot ulcers in people with diabetes, sharp debridement and basic wound dressings should be the primary approach, with consideration of adjunctive therapies such as topical oxygen therapy or hyperbaric oxygen therapy in specific cases 1.
- The use of topical oxygen therapy has been supported by several high-quality RCTs and systematic reviews, showing its efficacy in healing chronic diabetic foot ulcers at 12 weeks 1.
- Hyperbaric oxygen therapy may also be considered in selected cases, although its benefits are more limited and primarily seen in prevention of amputation in chronic neuroischemic ulcers 1. It is essential to prioritize the patient's overall health and well-being, considering the potential risks and benefits of each management approach, and to involve a multidisciplinary team in the care of patients with complex wounds 1.
From the Research
Management Options for Bruising and Impaired Wound Healing
- There are no direct management options for bruising and impaired wound healing associated with Zepbound (glucagon-like peptide-1 receptor agonist) therapy mentioned in the provided studies 2, 3, 4, 5, 6.
- However, the studies discuss the effectiveness and risks of GLP-1 receptor agonists in general, including their potential benefits and adverse effects 2, 3, 4, 5, 6.
Adverse Effects of GLP-1 Receptor Agonists
- The most common adverse effects of GLP-1RAs are gastrointestinal, which are transient and less common with the long-acting drugs 5.
- GLP-1RAs may also be associated with an increased risk of gastrointestinal disorders, hypotension, syncope, arthritic disorders, nephrolithiasis, interstitial nephritis, and drug-induced pancreatitis compared to usual care 4.
Benefits of GLP-1 Receptor Agonists
- GLP-1RAs have been shown to significantly improve glycemic parameters and reduce body weight 2, 5.
- They may also be associated with a reduced risk of substance use and psychotic disorders, seizures, neurocognitive disorders, coagulation disorders, cardiometabolic disorders, infectious illnesses, and several respiratory conditions compared to usual care 4.