From the Guidelines
Ozempic (semaglutide) should be stopped at least 3 weeks before surgery for patients taking it for weight loss, as suggested by recent guidelines 1. This recommendation is based on the medication's long half-life and its effects on gastric emptying, which may increase the risk of complications during surgery, particularly related to anesthesia. The decision to stop Ozempic before surgery should be made on a case-by-case basis, considering the individual patient's profile, the procedure, and the anaesthetic technique. It is essential to consult with both the prescribing physician and the surgeon to determine the best course of action for each patient. Additionally, the patient should discuss when to resume the medication after surgery, which typically occurs once they have returned to normal eating patterns and their surgical recovery is stable. The most recent guidelines suggest that the benefits of continuing GLP-1 receptor agonists, such as Ozempic, in the peri-operative period may outweigh the risks for patients with diabetes, but the risks may outweigh the benefits for patients without diabetes taking these medications for weight loss 1. Therefore, it is crucial to weigh the potential benefits and risks of stopping Ozempic before surgery and to make an informed decision based on the individual patient's needs and circumstances. Some studies suggest that stopping GLP-1 receptor agonists, such as Ozempic, at least 3 weeks before surgery may reduce the risk of pulmonary aspiration and other complications related to delayed gastric emptying 1. However, other studies suggest that the risk of pulmonary aspiration may be lower than previously thought, and that the benefits of continuing GLP-1 receptor agonists in the peri-operative period may outweigh the risks for some patients 1. Ultimately, the decision to stop Ozempic before surgery should be based on the most recent and highest-quality evidence available, as well as the individual patient's unique needs and circumstances. In general, it is recommended to stop Ozempic at least 3 weeks before surgery for patients taking it for weight loss, and to consult with both the prescribing physician and the surgeon to determine the best course of action for each patient 1. Key considerations include the patient's individual profile, the procedure, and the anaesthetic technique, as well as the potential benefits and risks of stopping Ozempic before surgery. By weighing these factors and considering the most recent evidence, healthcare providers can make informed decisions about the peri-operative management of patients taking Ozempic. The benefits of continuing GLP-1 receptor agonists, such as Ozempic, in the peri-operative period include improved peri-operative glycaemic control and a potential decrease in postoperative major adverse cardiac events 1. However, the risks of delayed gastric emptying and pulmonary aspiration must also be considered, particularly for patients taking these medications for weight loss 1. Overall, the decision to stop Ozempic before surgery should be based on a careful consideration of the potential benefits and risks, as well as the individual patient's unique needs and circumstances. Healthcare providers should consult with both the prescribing physician and the surgeon to determine the best course of action for each patient, and should consider the most recent and highest-quality evidence available when making decisions about the peri-operative management of patients taking Ozempic.
From the Research
Stopping Ozempic Before Surgery
- The decision to stop Ozempic (semaglutide) 2 weeks before surgery may be based on several factors, including the patient's medical history, the type of surgery, and the anesthesiologist's or surgeon's preferences 2, 3.
- There is no direct evidence in the provided studies that specifically addresses the need to stop Ozempic 2 weeks before surgery.
- However, it is known that semaglutide can affect glucose control and may increase the risk of hypoglycemia, particularly when used in combination with other diabetes medications or insulin 4, 5.
- In the context of surgery, maintaining stable blood glucose levels is crucial to prevent complications, and stopping Ozempic may be a precautionary measure to minimize the risk of hypoglycemia or other adverse events 2, 3.
- The studies provided focus on the efficacy and safety of semaglutide in patients with type 2 diabetes, its effects on weight loss and glycemic control, and its potential benefits in reducing postoperative complications 2, 3, 4, 6, 5.
- Further research is needed to determine the optimal management of semaglutide in the perioperative period, including the timing of discontinuation and restart of the medication.