From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Ozempic (semaglutide) should be held in a hospital inpatient setting for patients who are acutely ill, unable to eat, experiencing severe nausea/vomiting, or have acute kidney injury, as well as prior to procedures requiring NPO status or before surgeries requiring anesthesia, due to the risk of adverse effects such as acute pancreatitis, as reported in a recent case study 1.
Key Considerations
- The risk of acute pancreatitis associated with semaglutide use, as highlighted in recent case reports 1, 2, should be taken into consideration when deciding whether to hold Ozempic in a hospital setting.
- Patients with severe hyperglycemia requiring insulin drips should have Ozempic temporarily discontinued to avoid overlapping therapies and unpredictable glucose responses.
- Alternative glucose management with insulin is preferred in the inpatient setting, as it allows for more rapid titration based on changing clinical status.
- The long half-life of Ozempic (approximately one week) means that holding a dose during a brief hospitalization will not significantly impact glycemic control.
Clinical Guidance
- Ozempic should be held 24-48 hours prior to procedures requiring NPO status or before surgeries requiring anesthesia, depending on institutional protocols.
- Once the patient resumes oral intake and their condition stabilizes, Ozempic can be restarted prior to discharge if appropriate.
- The potential benefits of semaglutide, including improved glycemic control and weight loss, should be weighed against the potential risks, such as acute pancreatitis and anesthetic risks, as discussed in recent reviews 3, 4.
Evidence Summary
- Recent studies have highlighted the efficacy and safety of oral semaglutide in patients with type 2 diabetes 5, but the risk of adverse effects such as acute pancreatitis should not be overlooked.
- The most recent and highest quality study, a case report from 2024 1, suggests a potential link between long-term use and dose changes of GLP-1RAs, such as semaglutide, and severe pancreatitis.