Can You Take Ozempic If You’re Having Surgery?
Key takeaways:
Ozempic (semaglutide) is FDA-approved to treat Type 2 diabetes. It’s also FDA-approved to lower the risk of stroke and heart attacks in people with diabetes and heart disease.
Ozempic slows how quickly food passes through the gut. This can increase the risk of aspiration (choking) in people receiving anesthesia.
Experts recommend stopping Ozempic at least 1 week before surgery to lower the chances of aspiration.
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Ozempic (semaglutide) is an injectable medication that’s FDA approved to treat Type 2 diabetes. It’s also approved to lower the risk of serious cardiac events — like stroke and heart attacks — in people with Type 2 diabetes and heart disease.
Ozempic is a powerful medication, and it can cause side effects. Ozempic has been linked to higher risk of certain complications like vision problems and stomach paralysis (gastroparesis).
Experts have also noticed that Ozempic can increase the risk of aspiration — or choking — during surgery or other procedures that require anesthesia.
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People taking Ozempic are often asked to stop the medication a week or more before surgery. Let’s look at why you may be asked to stop Ozempic before surgery.
Why do you need to stop taking Ozempic before surgery?
If you’ve ever had a planned surgery or procedure, you may remember your surgical team instructing you to stop eating and drinking at a certain time before the procedure. This is to reduce your risk of aspiration: inhaling food or liquid from inside the stomach.
When your stomach is full, there’s more undigested food that can move up the throat and into the lung. Aspiration is a medical condition where food or liquid gets into the lung. It can lead to dangerous complications and even death.
Normally, your gag and cough reflex protect you from aspiration. But these reflexes can’t work when you receive anesthesia during surgery or a procedure.
Studies suggest that people taking Ozempic may be at higher risk for experiencing aspiration during anesthesia. That’s because Ozempic — and other glucagon-like peptide-1 (GLP-1 agonists) — slow gastric emptying. This means it takes longer for food to leave the stomach. So, even if you don’t eat for a day before surgery, there may still be food or liquid sitting in your stomach when you go for surgery.
When should you stop Ozempic before surgery?
Most experts recommend stopping Ozempic for a week before surgery.
Ozempic is a long-lasting medication. Here’s how long Ozempic stays in your system.
What’s anesthesia? Our experts review the different types of anesthesia and what to expect during your procedure.
Ozempic is a long-term medication. But what happens when you stop taking Ozempic?
Ozempic has a long half-life, which means that it lasts in the body for a long time. So it will take several days for Ozempic to fully leave the body after your last dose.
But there’s some debate about whether everyone on Ozempic needs to stop the medication before surgery.
One large review found that taking a GLP-1 agonist like Ozempic didn’t increase aspiration events during surgery.
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Experts have also looked at the data to try and figure out when people should stop Ozempic before anesthesia and surgery. They found that there’s no one-size-fits-all recommendation.
Instead, they recommend an individualized approach based on several factors, which are discussed below.
Medication dose
Higher doses of Ozempic are more likely to slow down movement of food from the stomach. If you’re taking a higher dose of Ozempic, you may need to slowly come off your medication over time.
Side effects
Ozempic can cause stomach-related issues such as:
Nausea
Vomiting
Abdominal discomfort
Constipation
These side effects are signs of slowed digestion. So, if you’re experiencing these side effects, you may need to stop taking Ozempic before your surgery.
Overall health
Other medical conditions — like Parkinson’s disease and gastroparesis — can affect how fast your digestive tract moves. If you have one of these conditions, you’ll be at higher risk for aspiration during anesthesia. You may need to stop Ozempic to lower your risk.
Planned surgery and anesthesia
Some surgeries require you to have an empty stomach before the procedure, while others don’t.
For example, a procedure like an upper endoscopy — also called an esophagoduodenoscopy (EGD) — involves looking into the stomach. If you’re getting this done, you’ll want your stomach to be empty before the procedure. That means you’ll have to stop taking Ozempic.
However, a procedure like cataract surgery is relatively quick and doesn’t involve general anesthesia. In this case, having a completely empty stomach isn’t as important, and you may be able to continue taking Ozempic.
Work with your healthcare team to figure out when is the best time to stop Ozempic. You may need to stop Ozempic for a longer period of time based on your medical history and your planned surgery.
Does Ozempic interfere with anesthesia?
No, Ozempic doesn’t interfere with any medications used for anesthesia. You’ll experience the same level of pain relief during and after your procedure or surgery as someone who doesn’t take Ozempic.
Right now, there’s no evidence that anesthesia medications wear off slower in people who take Ozempic.
When can you restart Ozempic after surgery?
There are no guidelines on when to resume Ozempic after surgery. In most cases, people are able to restart Ozempic within a day or two of surgery.
Your healthcare team will help you decide when it’s safe to restart Ozempic. This decision can depend on the following factors.
The type of surgery you had
If you had a prolonged surgery that involved the gastrointestinal (GI) tract, you may need to wait longer for the gut to recover before you take Ozempic again.
How quickly your gut recovers after surgery
General anesthesia and certain pain medications can lead to constipation. You may not be able to restart Ozempic until your bowel movements go back to normal. If your bowels return to normal soon after surgery, you’re more likely to get the go-ahead to restart Ozempic.
Your blood sugar levels
Keeping your blood sugar in a healthy range is important for your recovery. But stress from surgery can make it harder to keep your blood sugar in range.
One study showed that patients taking GLP-1 agonists after surgery had improved blood sugars and needed less insulin. Your healthcare team may ask you to restart Ozempic sooner if your blood sugar levels aren’t within a healthy range.
The bottom line
Most people need to stop taking Ozempic a week before a planned surgery or procedure. This helps reduce the risk of aspiration during anesthesia. But not everyone needs to stop taking Ozempic before anesthesia. And some people need to stop Ozempic for longer than a week. The decision depends on the type of surgery being performed, your medication dose, and your overall health. Your healthcare team can help you determine when you should stop taking Ozempic before anesthesia.
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References
American College of Surgeons. (n.d.). Blood sugar control.
Chang, M. G., et al. (2024). A scoping review of GLP-1 receptor agonists: Are they associated with increased gastric contents, regurgitation, and aspiration events? Journal of Clinical Medicine.
Hulst, A. H., et al. (2018). Systematic review of incretin therapy during peri-operative and intensive care. Critical Care.
Jalleh, R. J., et al. (2024). Gastrointestinal effects of GLP-1 receptor agonists: Mechanisms, management, and future directions. The Lancet Gastroenterology and Hepatology.
Joshi, G. P., et al. (2023). American Society of Anesthesiologists consensus-based guidance on preoperative management of patients (adults and children) on glucagon-like peptide-1 (GLP-1) receptor agonists. American Society of Anesthesiologists.
Kindel, T. L., et al. (2024). Multisociety clinical practice guidance for the safe use of glucagon-like peptide-1 receptor agonists in the perioperative period. Surgery for Obesity and Related Diseases.
Made For This Moment. (2023). Drugs for diabetes or weight loss. American Society of Anesthesiologists.
Silveira, S. Q., et al. (2023). Relationship between perioperative semaglutide use and residual gastric content: A retrospective analysis of patients undergoing elective upper endoscopy. Journal of Clinical Anesthesia.
