Poison control centers nationwide have seen a 1,500% jump in calls related to injected weight-loss medications that contain semaglutide, which is used for diabetes control and weight loss. Those include Ozempic, approved for diabetes, and Wegovy, for weight loss.
In 2023, through November, the centers have reported close to 3,000 related calls, a 15-fold increase since 2019.
A year ago, the U.S. Food and Drug Administration acknowledged a shortage of semaglutide, prompted in no small part by a plethora of glowing testimonials from celebrities who used semaglutide-based drugs and lost weight. Faced with short supplies, many patients turned to compounded versions of the drugs, which are not FDA-approved. Instead, the ingredients are mixed as a medication “recipe.”
As Health News explained, “If drugs meet the criteria for the Federal Food, Drug, and Cosmetic Act requirements, then drug compounding pharmacies are able to prepare the medication for the patients. Compounded versions require the patient to measure their own dosage, which may have contributed to recent overdose symptoms.”
The FDA had warned consumers about risks and urged them to buy the approved versions of the medication if they can. “But with cheaper out-of-pocket costs and accessibility, people continue to buy compounded versions,” Health News reported.
According to CNN, the FDA sent warning letters to at least two online sellers telling them to stop. Novo Nordisk, the pharmaceutical company that makes both Ozempic and Wegovy, has sued six medical spas, medical clinics and also weight-loss clinics to stop them from selling their own version of its licensed drug.
The poison control centers taking overdose calls cannot say for certain that the calls are related to compounded versions, but they suspect that is largely the case since the patented drugs are premeasured and the compounded ones must be drawn up at the correct dose from a vial before being injected. Some people make a dosing mistake.
That was the case in one of the calls that Dr. Joseph Lambson, director of the New Mexico Poison and Drug Information Center, said his team took. A woman, age 37, accidentally gave herself a milliliter instead of 0.1 milliliter — a 10-fold dose when she first began taking the drug. Typically, a prescribed first dose is smaller, then gets larger with subsequent doses as people adjust to the medication.
Lambson and colleagues reported on that and other cases in a June 2023 report in the Journal of the American Pharmacy Association.
The director of the Missouri Poison Center told CNN they got 28 calls about semaglutide in 2021. By October’s end, they’d received 94 calls for 2023.
People reported that “some affected people were hospitalized with symptoms including vomiting, severe nausea and abdominal pain. However, most cases were resolved with treatment such as intravenous fluids and antinausea medications.”
Symptoms of a semaglutide overdose, according to the Missouri Poison Center, are:
- Feeling lightheaded, shaky or dizzy.
- Sweating or chills.
- Irritability.
- Headache.
- Weakness.
- Fatigue.
- Nausea or vomiting.
- Seizures.
- Confusion.
- Fainting.
In most cases, patients are rehydrated with intravenous fluids and given antinausea medicine and sent home to recover, but some have required hospitalization.
The national poison control hotline number is 1-800-222-1222.