Please review HonorHealth’s important update to the preoperative protocol regarding withholding GLP-1 agonist medications for our patients taking them for diabetes or for weight loss, in order to avoid perioperative complications.

Situation:

The American Anesthesia Society (ASA) has released new recommendations on popular weight loss and diabetes medication Ozempic (semaglutide) and all medications in this drug category of GLP-1.

Background:

GLP-1 medication lowers blood sugar and also decreases “gastric emptying,” the process by which the stomach contents are moved into the small intestine, increasing the feeling of satiety by making one feel fuller faster and longer. As a result, there is increased risk of aspiration of food contents while under anesthesia with patients taking these medications if not held for a specific period of time pre-procedure.

Assessment:

The HonorHealth Anesthesia Team will continue to review the latest information for the safety of our patients. New guidelines indicate the following pre-procedure instruction with regard to GLP-1 medications:

• Hold oral GLP-1 agonists day of surgery.
• Hold injectable GLP-1 agonists seven days before surgery.

Recommendation:

Please begin sharing this new recommendation with our patients. Our Pre-admission testing office will also share this information in the pre-procedure phone call with the patient.

Continuing to take this medication could lead to a delay or cancellation.

Below is a common list of names of medications in this category:

GLP-1 medications:

• Mounjaro (tirzepatide) –injection
• Wegovy (semaglutide) –injection
• Revolex (semaglutide) –sublingual (oral) tablet
• Trulcity (dulaglutide) –injection
• Bydureon Bcise (exenatide ER) -injection
• Byetta (exenatide) twice- injection
• Ozempic (semaglutide)- injection
• Victoza, Saxenda (liraglutide) -injection
• Adlyxin (lixisenatide) – injection
• Rybelsus (semaglutide)- oral medication