From the Guidelines
No, Monjaro is not directly implicated in causing acute adrenal insufficiency. Monjaro is a GLP-1 receptor agonist primarily used for treating type 2 diabetes and weight management. The medication works by mimicking the incretin hormone GLP-1, which helps regulate blood sugar by increasing insulin secretion, decreasing glucagon secretion, slowing gastric emptying, and promoting satiety.
Causes of Acute Adrenal Insufficiency
Acute adrenal insufficiency is typically caused by sudden withdrawal of corticosteroid therapy, infections, trauma, or autoimmune conditions affecting the adrenal glands 1. While Monjaro may cause side effects such as nausea, vomiting, diarrhea, and decreased appetite, it does not directly affect adrenal function or cortisol production. If you're experiencing symptoms that might suggest adrenal insufficiency (such as severe fatigue, weakness, dizziness, weight loss, or electrolyte abnormalities) while taking Monjaro, these are likely unrelated to the medication and should be evaluated by a healthcare provider to determine the actual cause.
Management of Adrenal Insufficiency
According to the guidelines for the management of glucocorticoids during the peri-operative period for patients with adrenal insufficiency, hydrocortisone 100 mg by intravenous (i.v.) injection should be given at induction of anaesthesia in adult patients with adrenal insufficiency from any cause, followed by a continuous infusion of hydrocortisone at 200 mg.24 h-1, until the patient can take double their usual oral glucocorticoid dose by mouth 1. This regimen is preferred above others due to enhanced safety. It is essential to recognize and diagnose adrenal crisis as a medical emergency, and if in doubt about the need for glucocorticoids, they should be given as there are no long-term adverse consequences of short-term glucocorticoid administration 1. Patients with a long-standing diagnosis of adrenal insufficiency are often well informed about their disease, and anaesthetists should enquire closely about the patient’s history of glucocorticoid self-management, any previous episodes of adrenal crisis and how practised they are at medication adjustments for illness, injury or postoperative recovery 1. Best practice is to collaborate as far as possible with the patient’s endocrinologist when planning scheduled surgery, and when caring for postoperative patients. In cases where patients are at risk of adrenal crisis, it is crucial to increase the daily dose of glucocorticoids at times of physiological stress, such as during surgery or illness 1. By following these guidelines and recommendations, healthcare providers can effectively manage adrenal insufficiency and prevent adrenal crisis in patients.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Adrenal Insufficiency and Monjaro
- There is no direct mention of "monjaro" in the provided studies, making it difficult to establish a connection between monjaro and acute adrenal insufficiency.
- The studies focus on the diagnosis, treatment, and management of adrenal insufficiency, discussing various aspects such as hormone replacement regimens, patient education, and the importance of identifying life-threatening adrenal emergencies 2, 3, 4, 5, 6.
- Adrenal insufficiency is characterized by an absolute or relative deficiency of adrenal cortisol production, and its symptoms are non-specific, often overlooked or misdiagnosed 5.
- The goal of therapy is to establish a hormone replacement regimen that closely mimics the physiological diurnal cortisol secretion pattern, tailored to the patient's daily needs 5.
Causes and Management of Adrenal Insufficiency
- Primary adrenal insufficiency is caused by direct adrenal failure, while secondary adrenal insufficiency is caused by diseases affecting the pituitary, and tertiary adrenal insufficiency is caused by hypothalamic diseases 5.
- The management of adrenal insufficiency involves hormone replacement regimens, patient education, and the importance of identifying life-threatening adrenal emergencies 2, 3, 4, 5, 6.
- New approaches, including allograft of adrenocortical tissue and stem cell therapy, are being tried but remain largely experimental 6.