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

Some people using Ozempic or Wegovy have learned that too much of a good thing is never a good thing.

Semaglutide, under the brand names Ozempic for type 2 diabetes and Wegovy, is prescribed for weight control and mimics the hormone GLP-1, which is released from the gut after eating. The hormone has several effects in the body, such as stimulating insulin production, slowing gastric emptying and lowering blood sugar.

It has been praised for its weight loss benefits, most prominently among celebrities. Oprah Winfrey recently revealed that she uses weight-loss drugs and praised “the fact that in my lifetime there is a medically approved prescription for weight control and staying healthy.” He said it felt like a “gift.”

But between Jan. 1 and Nov. 30 of this year, at least 2,941 Americans reported overdosing on semaglutide, according to a recent report from the American Poison Control Center, a national nonprofit that represents 55 poison control centers in the United States.

According to Raymond Ho, CEO of the California Poison Control System, about 350 of the reports, or about 12%, were in California. Ho said that figure is roughly equivalent to California’s population as a percentage of the rest of the country.

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

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

Poison Control Centers of America released the data with a disclaimer that the numbers likely understate the number of semaglutide-related cases because the center included only those voluntarily reported to poison control centers.

“It’s an alarming trend from the point of view of the poison center,” Ho said. “We get regular dosing error calls, and all of a sudden people are calling a lot more often about this thing.”

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 semaglutide prescriptions were prescribed in the United States in 2020, according to federal data, and use of the drug has continued to grow ever since.

Dr. Stephen Petrou, an emergency physician and toxicology researcher for California Poison Control, said several factors contributed to the increase in overdoses.

Petrou said that the drug’s social popularity is not only growing, but the FDA’s indications for use are also broader.

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

Ho and Petrou said semaglutide’s different formulations may help explain why it has led to so many more overdoses than other drugs in its class. Both are given weekly as injections, Wegovy in disposable pens and Ozempic in needles, the dose of which can vary. Standard doses range from 0.25 mg to 2.4 mg for weekly injections, depending on the prescription.

“Someone who doesn’t get Wegovy can turn to Ozempic because it’s the same medicine, but they might start [adjust] up his dose, Petrou said. “That’s when they might run into trouble.”

Ho and Petrou said most reports of semaglutide overdoses are accidental, either because patients didn’t wait a week between doses or because they misunderstood the dosing instructions. Unlike the GLP-1 hormone, which is rapidly metabolized in the body, semaglutide and similar drugs have much longer half-lives, which means that the drug can accumulate in the body if there is not enough time between doses.

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

“We don’t see any cases where this drug has been misadministered, toxic or overdosed,” Petrou said.

Ho and Petrou explained that the signs of semaglutide overdose can resemble hypoglycemia, also known as low blood sugar. Symptoms can start 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 they need to be closely monitored and monitored because of the durability of these drugs,” Ho said.

Ho encourages anyone taking semaglutide to carefully read the drug’s label and follow the dosing instructions provided.

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

Anyone who needs poisoning help or has other poisoning-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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