From the Guidelines
Ozempic (semaglutide) is generally not recommended for patients with gastroparesis due to its potential to delay gastric emptying and worsen symptoms. As a GLP-1 receptor agonist, Ozempic works in part by slowing gastric emptying, which can exacerbate symptoms in patients who already have delayed gastric emptying from gastroparesis. Patients with gastroparesis typically experience nausea, vomiting, early satiety, and abdominal pain due to food remaining in the stomach for prolonged periods. Using Ozempic would likely exacerbate these symptoms by further delaying stomach emptying.
The most recent and highest quality study, published in 2024 1, supports this recommendation, advising caution when using GLP-1 RAs, including Ozempic, in patients with gastroparesis. This study highlights the importance of balancing the potential benefits of GLP-1 RAs against the risk of worsening gastrointestinal motility.
Key considerations for managing gastroparesis include:
- Withdrawing drugs with adverse effects on gastrointestinal motility, including opioids, anticholinergics, and GLP-1 RAs
- Using alternative medications that don't affect gastric motility for weight management or diabetes control
- Exploring other treatment options, such as domperidone, erythromycin, or gastric electrical stimulation, for severe cases of gastroparesis.
It is essential for patients with gastroparesis to discuss their condition thoroughly with their healthcare provider to determine the best course of treatment and explore safer options that won't worsen their digestive symptoms, as recommended by studies 1.
From the Research
Ozempic and Gastroperesis
- Ozempic (semaglutide) is a medication that has been associated with gastrointestinal side effects, including delayed gastric emptying and gastroparesis 2, 3, 4.
- Gastroparesis is a neurogastrointestinal disorder characterized by delayed gastric emptying without mechanical obstruction, and it can cause symptoms such as nausea, vomiting, bloating, and abdominal pain 5.
- The use of semaglutide has been reported to induce gastroparesis in some cases, and it may also increase the risk of pulmonary aspiration during anesthesia due to delayed gastric emptying 2, 3, 4.
- There is currently no specific guidance on the use of Ozempic in patients with gastroparesis, and more research is needed to determine the safety and efficacy of this medication in this population.
- Patients with gastroparesis who are taking Ozempic should be closely monitored for worsening symptoms, and alternative treatments may be considered if necessary 5, 6.
Management of Gastroparesis
- The management of gastroparesis typically involves a combination of nutritional support, medications, and procedures 5.
- Prokinetic agents, such as metoclopramide, may be used to improve gastric emptying, while antiemetic agents may be used to manage nausea and vomiting 5, 6.
- However, the use of opioid agents is not recommended in patients with gastroparesis, as they can worsen nausea and delay gastric emptying 6.
Precautions with Ozempic Use
- Patients taking Ozempic should be aware of the potential risk of delayed gastric emptying and pulmonary aspiration, particularly during anesthesia 2, 4.
- Anesthesiologists should be informed of the patient's use of Ozempic and take precautions to prevent pulmonary aspiration, such as adjusting the anesthetic technique or postponing elective surgeries 2, 4.