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

Some of those taking Ozempic or Vegovy are learning that too much of a good thing is never a good thing.

Semaglutide, a drug prescribed under the brand name Ozempic to treat type 2 diabetes, and Vegovy for weight management, works by mimicking the hormone GLP-1, which is released by the intestine after eating. The hormone has many effects in the body, such as stimulating insulin production, slowing gastric emptying, and lowering blood sugar.

It has been appreciated among celebrities for its weight loss benefits. Oprah Winfrey recently said that she uses weight loss medication and that she “appreciated the fact that there is a medically approved prescription to manage weight and stay healthy in my lifetime.” She said it felt “like a gift”.

But between January 1 and November 30 of this year, at least 2,941 Americans overdosed on semaglutide, according to a recent report from Poison Centers of America, a national nonprofit organization representing 55 poison centers in the United States. gave information.

About 350 of the reports, or about 12%, came from California, according to Raymond Ho, managing director of the California Poison Control System. Ho said that number roughly matches the ratio of California’s population to the rest of the country.

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

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

US poison centers released the data with a disclaimer that the figures probably represent an underestimation of the number of cases associated with semaglutide, as the centers only included people who voluntarily reported to poison control centers.

“This is an alarming trend from the poison center’s perspective,” Ho said. “We get routine calls about dosing errors, and suddenly there’s a flood of people calling about this on a much more regular basis.”

The use of semaglutide and other GLP-1 mimics has grown in popularity over 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 been rising steadily since then.

Dr. Stephen Petro, an emergency medicine physician and toxicology fellow at California Poison Control, said there were several factors contributing to the increase in overdoses.

“Not only is the drug’s social popularity increasing,” Petro said, but so are the 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 it was approved by the FDA in 2017. The drug was originally released as Ozempic for type 2 diabetes patients to manage blood sugar levels. Moderate weight loss was found to be a common side effect of the drug, and the FDA approved a different formulation of semaglutide, called Vegovy, for that purpose in 2021.

Ho and Petrou said that the different formulations of semaglutide may help explain why it has higher dosages than other drugs in its class. Both are administered via weekly injection, with Vegovy in a single-use pen and Ozempic in needles that may vary in dosage. Depending on the prescription, the standard dosage for weekly injections ranges from 0.25 mg to 2.4 mg.

“Someone who is unable to get Wegovi can use Ozempic instead, because it is the same drug, but they can start [adjust] Their dosage” upward, Petrou said. “That’s when they may face problems.”

Ho and Petro said that most reports of semaglutide overdose are accidental, either due to patients not waiting a week between doses or misunderstanding the dosing instructions. Unlike the GLP-1 hormone, which is rapidly metabolized by the body, semaglutide and similar drugs have a very long half-life, meaning the drug can accumulate inside the body if there is not enough time between doses. Is.

In addition, semaglutide can also be taken orally as a daily tablet sold under the name Ribelsus, but overdose has rarely been reported.

“We are not seeing cases of misadministration or toxicity or overdose of that drug,” Petrou said.

Ho and Petro noted that symptoms of semaglutide overdose may be similar to those 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 will have to be hospitalized and monitored and monitored closely, because of how long these medications last,” Ho said.

Ho encourages everyone who is prescribed semaglutide to read the medication label thoroughly and follow the dosage instructions listed.

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

Anyone who needs emergency poison assistance or has other poison-related inquiries 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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