From the Guidelines
Semaglutide (Ozempic) should be held for at least 7-10 days before a colonoscopy, as the most recent and highest quality study suggests an increased risk of pulmonary aspiration and delayed gastric emptying associated with GLP-1 receptor agonist use in the peri-operative period 1. This recommendation is based on the medication's potential to delay gastric emptying and slow intestinal transit, which could interfere with bowel preparation effectiveness. The study by Silveira et al. found that patients taking semaglutide had a significantly higher incidence of residual gastric content compared to the control group, despite extended fasting times 1. Additionally, the study by Kobori et al. also found a significantly higher incidence of gastric residue in the GLP-1 receptor agonist treatment group 1. It is essential to prioritize the patient's safety and minimize the risk of complications during the procedure. After the colonoscopy, you can resume your regular Ozempic dosing schedule once you're eating normally again. Always consult with both your prescribing physician and gastroenterologist about specific timing for your situation, as individual factors may require adjustments to this general recommendation. Some key points to consider include:
- The risk of pulmonary aspiration and delayed gastric emptying associated with GLP-1 receptor agonist use in the peri-operative period
- The importance of proper bowel preparation to ensure the effectiveness of the colonoscopy
- The need to balance the risks and benefits of holding Ozempic before the procedure
- The importance of individualized care and consultation with healthcare providers to determine the best course of action for each patient.
From the Research
Eozempic and Colonoscopy Preparation
- There is no direct evidence on how long eozempic should be held prior to colonoscopy.
- However, studies suggest that glucagon-like peptide-1 receptor agonists (GLP-1RAs), such as eozempic, can affect the quality of bowel preparation for colonoscopy 2.
- GLP-1RAs can slow gastric emptying and colonic transit, which may impact the adequacy of colonic preparation 2.
- The European Society of Gastrointestinal Endoscopy (ESGE) recommends a low fiber diet on the day preceding colonoscopy, enhanced instructions for bowel preparation, and split-dose bowel preparation for elective colonoscopy 3.
- For patients undergoing afternoon colonoscopy, a same-day bowel preparation is suggested as an acceptable alternative to split dosing 3.
- The last dose of bowel preparation should be started within 5 hours of colonoscopy and completed at least 2 hours before the beginning of the procedure 3.
Considerations for Diabetic Patients
- Diabetic patients have distinct risks during precolonoscopy bowel preparation, including hypoglycemia, water and electrolyte imbalance, and poor bowel preparation 4.
- The use of GLP-1RAs, such as eozempic, may increase the risk of inadequate bowel preparation in diabetic patients 2.
- A comprehensive review of the literature suggests that multiple strategies can be used to improve bowel preparation in diabetic patients, including pharmacologic and non-pharmacologic approaches 5.