Semaglutide, the active ingredient in popular drugs Ozempic and Wegovy, isn’t without its risks. A recent study has found that tens of thousands of Americans have ended up in the emergency room from taking semaglutide over the past few years.
Scientists from the Centers for Disease Control and Prevention led the research, published this month in Annals of Internal Medicine. Based on national surveillance data, the researchers estimate that semaglutide contributed to nearly 25,000 ER visits between 2022 and 2023, usually from gastrointestinal complications. The findings suggest that doctors can do more to mitigate the potentially severe side effects of these drugs, the researchers say.
Semaglutide and similar drugs mimic GLP-1, one of several hormones that play a key role in regulating our metabolism and hunger. GLP-1 drugs have existed for over two decades, but semaglutide is part of a newer and more effective generation. It was first approved in 2017 to treat type 2 diabetes under the brand name Ozempic. In 2021, it was approved to treat obesity under the brand name Wegovy. Since then, doctors have also commonly prescribed Ozempic off-label for weight loss.
Every drug comes with its side effects, however. People taking GLP-1s commonly experience nausea, diarrhea, and other GI symptoms. Usually, these side effects are mild and/or tend to decline over time. But in some cases, they can become serious enough to warrant emergency medical care.
The CDC researchers analyzed data from the National Electronic Injury Surveillance System-Cooperative Adverse Drug Event Surveillance Project (NEISS-CADES), which keeps track of drug-related adverse events reported to a nationally representative sample of emergency departments in the U.S.
Based on 551 documented cases, the researchers estimated that 24,499 ER visits were attributable to semaglutide use between 2022 and 2023. Nearly 70% of these visits involved GI symptoms, while roughly 17% involved hypoglycemia (low blood sugar), and about 6% represented allergic reactions. About a third of hypoglycemia-related visits led to hospitalization, as did 15% of GI-related visits.
The findings should be taken in some context. Many drugs can cause side effects that could result in an ER visit, including common over-the-counter medications. In a 2021 study from many of the same authors, they found that roughly 1 in 200 Americans visit the ER each year due to medication-related harms, for instance, with two-thirds caused by therapeutic use (meaning that the drugs were taken to treat a medical problem, not recreationally). A 2022 study by the same team estimated that OTC cough or cold medications cause about 27,000 ER visits in the U.S. annually.
But the results of this latest study shouldn’t be minimized either. More than 82% of the ER visits happened in 2023, suggesting that as semaglutide use has surged, so have its potential harms. About 9% of the visits involved medication errors, such as people taking more than instructed. So we might be able to prevent some ER visits with better patient education. In other cases, doctors could lower their patients’ risk of serious complications by better managing their use of other medications, and at the very least, they can probably do more to prepare their patients in advance before starting GLP-1 therapy, the researchers argue.
“Clinicians could counsel patients when initiating semaglutide about the potential for severe gastrointestinal adverse effects and adjust co-prescribed antidiabetic medications to decrease hypoglycemia risk,” the authors wrote.