What is the association between Ozempic (semaglutide) and venous thromboembolism (VTE)?

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Last updated: March 20, 2025View editorial policy

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From the Guidelines

Ozempic (semaglutide) has not been shown to increase the risk of venous thromboembolism (VTE) in the provided evidence, and its use may potentially have protective effects against thrombotic events due to its beneficial impacts on weight loss, blood pressure, and glycemic control. The evidence provided does not directly address the association between Ozempic and VTE, but it discusses the risk factors and prophylaxis for VTE in various patient populations 1.

Key Points to Consider

  • The provided evidence focuses on VTE prophylaxis in patients undergoing surgery and those with cancer, highlighting the importance of risk assessment and management 1.
  • GLP-1 receptor agonists like Ozempic may have beneficial effects on cardiovascular risk factors, including weight loss, blood pressure, and glycemic control, which could potentially reduce the risk of thrombotic events.
  • Patients taking Ozempic should undergo standard risk assessment for VTE, and those with pre-existing VTE risk factors should be managed according to standard guidelines regardless of Ozempic use.

Management and Prevention

  • The typical Ozempic dosing starts at 0.25 mg once weekly for 4 weeks, then increases to 0.5 mg weekly, with possible further titration to 1 mg or 2 mg weekly based on glycemic response and tolerability.
  • Patients with pre-existing VTE risk factors, such as obesity, immobility, prior VTE history, or certain genetic conditions, should be managed according to standard guidelines, including the use of compression stockings, intermittent pneumatic compression, and anticoagulants like low molecular weight heparin, as recommended by the evidence 1.

From the Research

Association between Ozempic (semaglutide) and Venous Thromboembolism (VTE)

There is no direct evidence in the provided studies to establish an association between Ozempic (semaglutide) and venous thromboembolism (VTE).

General Information on Venous Thromboembolism (VTE)

  • VTE, including deep vein thrombosis (DVT) and pulmonary embolism, represents a significant source of morbidity and mortality 2.
  • VTE prophylaxis is recommended for acutely ill, hospitalized medical patients at risk of thrombosis 3.
  • Anticoagulant therapy is recommended for at least 3 months in patients with acute VTE to prevent recurrence 4.
  • Critically ill patients are at an increased risk of VTE compared to general medical patients due to unique risk factors 5.

Treatment and Prevention of VTE

  • Novel oral anticoagulants (NOACs) have demonstrated comparable efficacy and comparable or superior safety in large, randomized clinical trials in the treatment and prevention of VTE compared with conventional therapy 4.
  • Clinical practice guidelines recommend VTE prophylaxis with either subcutaneous heparin or low-molecular-weight heparin for all critically ill patients without contraindication 5.
  • The use of unfractionated heparin three-times-daily, low-molecular-weight heparin once-daily and fondaparinux once-daily has demonstrated effectiveness in clinical trials of medically ill patients 6.

Limitations of Current Studies

  • The provided studies do not investigate the specific relationship between Ozempic (semaglutide) and VTE.
  • Further research is needed to determine the association between Ozempic (semaglutide) and VTE.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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