Emergency Rooms Should Be Ready to Handle Ozempic, Mounjaro Side Effects, Doctor Warns

Doctors should discuss with patients the risks of aspiration during sedation due to Ozempic, Mounjaro stomach paralysis side effects, letter indicates.

As concerns over the side effects of Ozempic, Mounjaro and similar diabetes and weight loss drugs continue to mount, a doctor is warning emergency rooms that they need to be better prepared to treat patients taking the drugs.

In the August edition of the Annals of Emergency Medicine, Dr. William Dixon from the Department of Emergency Medicine at Stanford Health Care, raised concerns about the risk of gastroparesis, or stomach paralysis, among patients taking a new class of medications known as glucagon-like peptide-1 receptor agonists (GLP-1 RAs), which include the blockbuster treatments Ozempic, Wegovy, Mounjaro, and Zepbound.

In his letter to the editor, Dr. Dixon highlighted that this condition could significantly increase the risk of aspiration or vomiting among patients who are sedated for surgery, warning that more should be done to discuss the risks with patients and prepare to address problems that may develop in the emergency room.

Ozempic, Mounjaro Side Effects Concerns

Ozempic (semaglutide) was initially introduced for the treatment of people with Type 2 diabetes in late 2017. However, amid aggressive advertisements that promoted the weight loss benefits, Ozempic has been increasingly prescribed as a diet drug in recent years, making it a blockbuster treatment that is now used by millions of Americans.

Due to the initial success of Ozempic in the weight loss market, Novo Nordisk subsequently launched Wegovy, a higher dose version of semaglutide that was specifically approved as a diet medication. Similarly, Eli Lilly received FDA approval for its Type II diabetes drug Mounjaro (tirzepatide) in 2022, and its weight loss counterpart, Zepbound was approved by the FDA last year.

Although advertisements promote the drugs as safe and effective, with few long-term side effects, GLP1 RAs have been linked to a number of potentially serious health risks, including gastroparesis side effects, and non-arteritic anterior ischemic optic neuropathy (NAION) vision problems, which can cause sudden vision loss due to a lack of blood flow to the optic nerve.

As a result of the drug makers’ failure to adequately warn about these risks, thousands of former users are now pursuing Ozempic lawsuits, Wegovy lawsuits and Mounjaro lawsuits against the manufacturers, each raising similar allegations that the manufacturers placed a desire for increased profits above consumer safety by failing to research and adequately disclose side effects users may experience.

Ozempic Aspiration Risks in Emergency Rooms

Ozempic and the other GLP1-RA medications work by delaying gastric emptying, which promotes weight loss, since users feel full longer. However, in some cases the delayed gastric emptying can lead to complete stomach paralysis, intestinal or bowel obstructions and other complications. In addition, experts have begun to recognize that the delayed gastric emptying poses a serious risk of anesthesia aspiration during surgery, which can occur when a patient inhales the contents of their own stomach when sedated during a procedure.

In June 2023, the American Society of Anesthesiologists (ASA) issued a warning about the Ozempic aspiration risks, encouraging doctors to have patients stop taking the drugs before any elective procedure. However, this is not possible for emergency procedures.

Dixon noted in his letter that the American College of Emergency Physicians still urges emergency rooms to provide patients with “sedation without delay, regardless of fasting status.” However, Dixon notes that if doctors are unaware a patient is taking Ozempic or a similar drug, they may be unprepared for aspiration complications that do arise during surgery, which could lead to patients suffocating.

“Although treatment of side effects of GLP-1 agonists can be straightforward, the use of GLP-1 agonists may increase the risk of aspiration in the patient requiring intubation or procedural sedation. Given the indications for use, any patient on a GLP-1 agonist is likely to already be at risk due to a combination of type 2 diabetes mellitus, obesity, obstructive sleep apnea, or bariatric surgery,” Dixon states. “Further, the mechanism of action may lead to transient or long-term gastroparesis.”

Dixon indicated that previous studies have shown 25% of patients taking Ozempic or Wegovy who fasted before undergoing endoscopy still had residual contents in their stomach. That compared to only 5% of patients who did not take the drugs.

He called for emergency rooms to consider patients taking GLP-1 RAs to be at high risk for procedural sedation or endotracheal intubation. Dixon indicated emergency rooms could mitigate the risks for intubation by elevating patients’ heads, decreasing the use of bag-valve-masks for oxygenation, and making sure their most capable air operators are in attendance.

The letter also called for health care providers to discuss the risk of aspiration with patients, which should be documented to “potentially prevent legal ramifications.”

August 2024 Ozempic, Mounjaro Lawsuits Update

Given the widespread use of Ozempic, Mounjaro and other GLP1-RA medications, thousands of individuals are now pursuing failure to warn lawsuits against the manufacturers, each raising similar allegations and questions of law.

To help manage and coordinate pretrial proceedings, the U.S. Judicial Panel on Multidistrict Litigation established a GLP-1 RA drug lawsuits earlier this year, centralizing claims brought throughout the federal court system in the Eastern District of Pennsylvania, for coordinated discovery and pretrial proceedings.

Earlier this month on July 14, the judge now presiding over the litigation issued a pretrial order authorizing the direct filing of new Ozempic lawsuits in the federal MDL, which will avoid delays associated with transferring claims from various different federal district courts nationwide.

As part of the coordinated management of the growing litigation, it is expected that the parties will identify a small group of “bellwether” cases to prepare for early trial dates, which will help gauge how juries may respond to certain evidence and testimony that will be repeated throughout the claims.

However, if the parties are unable to negotiate GLP1 settlements or another resolution for the litigation following any early test trials, each individual lawsuit may later be remanded back to the U.S. District Court where it was originally filed for a separate trial date in the future.