Ozempic overdose? Poison control experts explain why thousands OD this year

Some who take Ozempic or Wegovy learn that too much of a good thing is never a good thing.

Semaglutide, the drug prescribed under the brand names Ozempic, for the treatment of Type 2 diabetes, and Wegovy, for weight management, works by mimicking the hormone GLP-1, which is released by the gut after eating. The hormone has several effects on the body, such as stimulating the production of insulin, slowing the emptying of the stomach and lowering blood sugar.

It has been praised for its weight loss benefits, most notably among celebrities. Oprah Winfrey recently said she uses weight loss medication and praised “the fact that there is a medically approved prescription for weight management and staying healthy, in my life.” He said it was like a gift.

But between January 1 and November 30 this year, at least 2,941 Americans reported an overdose of exposure to semaglutide, according to a recent report from America’s Poison Centers, a national nonprofit that represents 55 poison center in the United States.

California accounted for about 350 of the reports, or about 12%, according to Raymond Ho, the managing director of the California Poison Control System. Ho said the number roughly matches the proportion of California’s population to the rest of the country.

The nationwide number of semaglutide overdoses this year is more than double the 1,447 reported in 2022, which is more than double the 607 semaglutide overdoses reported in 2021.

There were only 364 reported semaglutide overdoses in 2020 and 196 in 2019, less than 10% of the number that have occurred so far this year.

America’s Poison Centers released the data with a disclaimer that the numbers likely represent an undercount of the number of cases involving semaglutide, because the center only included volunteers reported to poison control centers.

“This is an alarming trend from a poison center perspective,” Ho said. “We were getting the usual dosing error calls, and all of a sudden there was an explosion of people calling about it more regularly.”

The use of semaglutide and other GLP-1 mimics has gained popularity in the past year as a quick and effective way to manage weight loss. More than 4 million prescriptions for semaglutide were issued in the United States in 2020, according to federal data, and use of the drug has grown steadily since then.

said Dr. Stephen Petrou, an emergency medicine physician and toxicology associate at California Poison Control, said there are many factors contributing to the increase in overdoses.

“Not only is there an increasing societal popularity” of the drug, Petrou said, “but there are also broader FDA indications for use.”

Semaglutide was patented by the Danish pharmaceutical company Novo Nordisk in 2012 and has been available in the United States since its FDA approval in 2017. The drug was originally released as Ozempic for Type 2 diabetics to manage sugar levels in the blood. Moderate weight loss was found to be a common side effect of the drug, and the FDA approved a different formulation of semaglutide, called Wegovy, for that purpose in 2021.

Ho and Petrou said the different formulations of semaglutide may help explain why it leads to more overdoses than other drugs in its class. Both are administered through weekly injections, with Wegovy in single-use pens and Ozempic in needles that can vary in dosage. Common doses range from 0.25 mg to 2.4 mg for weekly injections, depending on the prescription.

“Someone who can’t get Wegovy can use Ozempic instead, because it’s the same drug, but they can start [adjust] their dose” up, says Petrou. “That’s when they can run into problems.”

Ho and Petrou said most reports of semaglutide overdoses are accidental, either due to patients not waiting a week between doses or by misunderstanding the dosing instructions. Unlike the GLP-1 hormone, which is quickly metabolized by the body, semaglutide and similar drugs have a longer half-life, meaning the drug can build up inside the body if not enough time has passed. between doses.

Furthermore, semaglutide can also be taken orally as a daily pill sold under the name Rybelsus but overdoses have rarely been reported.

“We don’t see any cases of misadministration or toxicity or overdose with that drug,” Petrou said.

Ho and Petrou explained that the signs of semaglutide overdose can be similar to the symptoms of hypoglycemia, also known as low blood sugar. Symptoms may begin with increased heart rate, sweating, dizziness and irritability. More severe cases can cause confusion, delirium and coma.

“If they have hypoglycemia, most of them need to be admitted to the hospital and monitored and watched closely, because of how long these drugs take,” Ho said.

Ho encourages everyone prescribed semaglutide to read the drug label carefully and follow the dosing instructions listed.

“We always say this: The dose makes the poison,” Ho said.

Anyone who needs emergency poison help or has other poisoning-related questions can call the national Poison Helpline at (800) 222-1222 or visit the Poison Help website.

This story originally appeared in the Los Angeles Times.

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