Poison centers see 1,500% increase in calls related to injectable weight-loss drugs, with people accidentally taking overdoses

CNN
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Poison control centers across the United States They say they are seeing a sharp increase in calls related to semaglutide, an injectable medication used to treat diabetes and weight loss, with some people reporting symptoms associated with accidental overdoses.

Some required hospitalization for severe nausea, vomiting and stomach pain, but their condition appeared to resolve after they were given intravenous fluids and medications to control the nausea.

From January to November, U.S. poison centers reported nearly 3,000 calls involving semaglutide, a more than 15-fold increase since 2019. In 94% of calls, that drug was the only substance reported.

Dr Kate Brown, managing director of the Clinical Society, said that in most calls, people reported errors in dosing.

“A lot of times, it’s the person who accidentally took a double dose or took the wrong dose,” Brown said.

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Semaglutide was approved by the US Food and Drug Administration in 2017. It is sold under the name Ozempic when used for diabetes and Wegovy when used for weight loss. Even when used as directed by a doctor, people can experience stomach and intestinal side effects, including nausea, vomiting, and constipation, especially when they first start taking medications.

After celebrities began publicly embracing Ozempic on social media in 2022 as a way to lose weight, demand overwhelmed supply. A shortage occurred in the FDA database in March 2022, opening the door for some eligible pharmacies to produce compounded versions.

Compounded versions of semaglutide are often different from the patented medicine. Contains many Salts of semaglutide are called semaglutide sodium and semaglutide acetate. The FDA says the salt forms in the drug have not been tested and approved to be safe and effective in the way they are patented. The dosage form exists, and therefore they do not qualify for the double exemption in the law for drugs in shortage. In other cases, compounded versions are sold in unapproved doses.

The FDA sent letters to at least two online sellers warning them to stop. Pharmaceutical company Novo Nordisk has filed a lawsuit to prevent six spas, medical clinics and weight-loss clinics from selling counterfeit versions.

But these combination versions are popular because they may be less expensive, especially if the treatment is not covered by insurance.

The US Food and Drug Administration warned the public in June against taking compounded versions of the drug if prescription forms are available. The agency said it had received reports of adverse events after people used compounded versions of the drug.

Poison control centers say reported symptoms don’t allow them to know whether the calls stem from patented drugs or compounded versions, but some state poison center directors say they believe compounded versions are behind many of the calls.

Dr. Joseph Lampson, director of the New Mexico Poison and Drug Information Center, detailed what happened to three people who called Utah’s poison control hotline, which has seen calls related to semaglutide rise nearly four times between 2021 and 2022. Books on cases in the Journal of the American Pharmaceutical Association

Two of the callers accidentally took 10 times the standard dose of the drug.

“We’ve had reports of people giving themselves doses that we’ve never heard of before,” Lampson said. “That’s what sparked our interest” in tracking calls.

Brand-name medications are sold in prefilled pens, which come with some warranties. Patients order the correct dose and then click to inject, so it becomes difficult to make mistakes. Usually, people start with lower doses and over time reach the therapeutic amount so their bodies can adapt.

However, combination versions usually come in multi-dose glass vials, and patients draw their own doses into syringes. It’s easy to feel confused.

“This is where we see a lot of mistakes. They end up drawing too much,” Lampson said.

One call Lampson’s team received was from a 37-year-old woman who mistakenly gave herself 1 milliliter instead of 0.1 milliliters – 10 times the recommended amount – as her first dose for weight loss.

A 50-year-old man mistakenly gave himself 50 units instead of 5 units as his first dose for weight loss. He vomited for two days and had nausea for a week.

“I think when we have to rely on the patient to know the correct dose, draw it and then administer it, you create more opportunities for errors to occur,” Brown said.

A third caller, a 33-year-old woman, reported getting semaglutide at a spa but did not know the dosage. I went to the emergency room because of persistent vomiting and abdominal pain. She was given anti-nausea medication and intravenous fluids, and was discharged from the hospital later that day.

Julie Weber, director of the Missouri Poison Center, said she received 28 calls related to semaglutide in 2021. This year, through October, she received 94 calls.

Semaglutide-related calls stand out in the data in another way, too. Although most calls to poison centers are about young children who have accidentally ingested something, these calls are from adults ages 40 to 70, with the largest group being ages 60 to 69.

Weber says the appeals they’re seeing in their system aren’t just related to injecting compounded forms of the drug. Many of their calls are related to the click pen that comes with the prescription medication, Weber said.

In one case, a caller said he was having trouble with the pen and accidentally called him in, giving himself an entire month’s worth of doses at once.

“They misunderstood the pen. They didn’t know how to use it properly and asked for it too and took the entire pen instead of just the dose that was supposed to happen,” Weber said.

In other cases, reported at this year’s meeting of the American College of Medical Toxicology from a poison control center in New York City, people have needed to be hospitalized. One of these patients accidentally took 20 times the recommended amount.

In a written statement, Novo Nordisk, the maker of Ozempic and Wegovy, said patient safety is its top priority.

“We are taking multiple steps to ensure the responsible use of our semaglutide medications, which are detailed on semaglutide.com,” the statement said.

There is no specific antidote for semaglutide overdose. The drug has a half-life of about one week, which means it takes one week to remove half of it from your body. Emergency departments and hospitals can only help support patients with intravenous fluids and anti-nausea medications as the medication exits their bodies.

In addition to nausea and vomiting, the Missouri Poison Center warns people who think they have taken an overdose to watch for signs of low blood sugar, or hypoglycemia, which can be dangerous. Hypoglycemia is more common with semaglutide if you also take other diabetes medications.

According to the Missouri Poison Center, there are signs of semaglutide Overdose includes:

If you think you’ve overdosed on a weight-loss medication, Brown said the best thing you can do is call your local poison control center or national hotline at 800-222-1222.

“This way, a specialist will be able to take specific information about their condition in terms of how much they have taken, what type of overdose they are experiencing… and decide whether they are safe to stay home or whether or not to go home.” “They need to seek medical care, especially if they develop symptoms,” Brown said.