Can Ozempic (semaglutide) cause tachyarrhythmias?

From the Guidelines

Yes, Ozempic (semaglutide) can cause tachyarrhythmias, although the evidence suggests that this is not a common adverse effect.

Adverse Effects of Semaglutide

• The most frequently reported adverse effects of GLP-1 receptor agonists, including semaglutide, are nausea, vomiting, and diarrhea 1.
• Cardiac arrhythmia/tachycardia is listed as a potential adverse effect of GLP-1 receptor agonists, with management recommendations to monitor and consider beta blockers if symptomatic 1.

Cardiovascular Effects of Semaglutide

• The SUSTAIN-6 trial showed that semaglutide reduced the risk of major adverse cardiovascular events, including cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke, in patients with type 2 diabetes 1.
• The PIONEER 6 trial demonstrated that oral semaglutide was non-inferior to placebo for the primary composite outcome of cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke 1.

Clinical Implications

• While semaglutide has been shown to have cardiovascular benefits, caution is advised when using this medication in patients with a history of cardiac arrhythmias or tachycardia.
• Monitoring and consideration of beta blockers may be necessary if symptoms of cardiac arrhythmia/tachycardia occur 1.

From the FDA Drug Label

In placebo-controlled trials, OZEMPIC 0.5 mg and 1 mg resulted in a mean increase in heart rate of 2 to 3 beats per minute.

Tachyarrhythmias are not directly mentioned in the provided drug labels. However, an increase in heart rate is reported. The FDA drug label does not directly answer the question of whether Ozempic (semaglutide) can cause tachyarrhythmias.

From the Research

Tachyarrhythmias and Ozempic (Semaglutide)

• The provided studies do not directly address the question of whether Ozempic (semaglutide) can cause tachyarrhythmias.
• However, the studies do provide information on the effects of semaglutide on atrial fibrillation, which is a type of arrhythmia.
• According to the studies, semaglutide has been shown to reduce the risk of atrial fibrillation in patients with type 2 diabetes and those at high risk of cardiovascular events 2, 3, 4.
• One study found that semaglutide reduced the risk of atrial fibrillation by 42% compared to placebo 3.
• Another study found that semaglutide decreased the occurrence of atrial fibrillation compared to control drugs, with a relative risk of 0.70 (95% CI 0.52-0.95) 4.
• The STEP-HFpEF Program found that semaglutide led to larger improvements in heart failure-related symptoms and physical limitations in participants with atrial fibrillation compared to those without atrial fibrillation 5.

Cardiovascular Effects of Semaglutide

• Semaglutide has been shown to have a good safety profile in general, with a reduced risk of major adverse cardiovascular events (MACE) compared to placebo 6.
• The SUSTAIN and PIONEER trials found that semaglutide reduced the risk of MACE by 26% compared to placebo 6.
• Semaglutide has also been shown to reduce the risk of deep vein thrombosis and increase the risk of diarrhea 2.

Limitations

• The provided studies do not directly address the question of whether Ozempic (semaglutide) can cause tachyarrhythmias, and therefore, the evidence is not directly relevant to this question.
• Further studies would be needed to determine the effects of semaglutide on tachyarrhythmias specifically.