Poison Center Calls For Semaglutide Weight-Loss Drugs More Than Doubled After FDA Approval

When the FDA approved Wegovy, the weight-loss version of semaglutide, in 2021, demand for GLP-1 drugs surged. Simultaneously, calls to poison centers for these drugs increased dramatically. Semaglutide is also sold as Ozempic for type 2 diabetes, and the two brand names are often used interchangeably in public conversation, even though they serve different purposes.

A new study published in the Journal of Medical Toxicology tracked every reported exposure to this class of weight-loss and diabetes drugs, known as GLP-1 receptor agonists, logged in a national poison center database from 2012 through 2023. After the FDA’s 2021 approval, reported exposures more than doubled, and unintentional therapeutic errors remained the most common reason people contacted poison centers, even though most cases were medically mild.

Injectable medications in this class work partly by slowing down how quickly food leaves the stomach, which curbs appetite and aids weight loss. Some research also suggests they may affect cravings more broadly, which has fueled interest well beyond their original use. Before 2021, they were more commonly used by older patients managing blood sugar. After approval for weight loss, the patient profile changed dramatically, and so did the pattern of errors.

A Sharp Rise in Calls and a Changing Patient Profile

Researchers analyzed 10,033 reported drug exposure cases drawn from the National Poison Data System, a database maintained by America’s Poison Centers that compiles records from poison control centers across all U.S. states and territories. Of those cases, 3,113 occurred before July 1, 2021, and 6,920 occurred on or after that date. Semaglutide alone accounted for nearly two-thirds of all post-approval cases, at 64.2%. Using a statistical modeling method designed to detect meaningful shifts in trends over time, researchers confirmed that semaglutide-related calls were growing at an additional 9.9% per quarter after the approval, far outpacing the modest growth seen among other drugs in the same class.

Callers also skewed younger and more female after the approval. Before 2021, the average age of patients was 57 years. After approval, it dropped to around 52. When researchers accounted for the likely continuation of the older, diabetes-focused patient base, they estimated the average age of newly affected patients was closer to 47.5 years. Women made up a larger share as well: 78.2% of post-approval cases, compared with 68.9% before.

Mostly Mistakes, Mostly Mild, But More People Sought Emergency Care

In both time periods, the most common reason someone called a poison center was an unintentional mistake: taking the wrong dose, taking it at the wrong time, or mixing up medications. Symptoms were, more often than not, on the milder end, including nausea, vomiting, stomach pain, diarrhea, dizziness, and headache.

Despite the generally non-severe nature of these incidents, people were seeking emergency care at much higher rates. Before 2021, about 23% of callers were either already at a medical facility or were referred to one. After approval, that figure climbed to 33.5%, and cases where patients were treated and released from an emergency department rose from 13% to over 21%.

Researchers point to several possible explanations. Far more people are now taking these drugs, and many are newer users who may be less familiar with the injectable delivery devices, pens that must be dialed and administered correctly. Historical data cited in the paper found error rates of 17% to 57% for first-time users of similar injectable pens.

Drug shortages during the same period also pushed some patients toward compounded versions of these medications, which can have non-standard concentrations and create additional opportunities for dosing confusion. The authors also suggest that widespread media coverage and social media attention may have lowered the bar for what prompts someone to call a poison center or head to an ER, even when symptoms could be managed at home.

One Documented Death, and a Question About Surgical Timing

While most outcomes were mild, the data did include one death. A patient with a history of obesity had recently undergone liposuction, with tirzepatide, another drug in the GLP-1 class sold as Mounjaro and Zepbound, started three weeks after the surgery. Ten days later, that patient arrived at an emergency department with severe abdominal pain and bloating following several days of constipation. Surgery revealed extensive damage to the large intestine, and the patient did not survive. Cause and effect cannot be established from a single case report, but the authors flag the timing as raising clinical questions about the use of these drugs around the time of surgical procedures.

Better Patient Education Could Prevent Many Errors

Better upfront education for both patients and the doctors prescribing these medications could prevent many of these incidents, according to the authors. Instructions on how to correctly use the injection devices, what side effects to expect, and when it is truly necessary to seek emergency care versus managing symptoms at home could reduce unnecessary pressure on emergency departments.

More prescriptions and less familiarity turned out to be a costly combination. Even with mostly mild symptoms driving the calls, the spike in emergency visits shows that patient education has not kept pace with the drug’s explosive popularity.

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Disclaimer: This article is based on a published scientific study and is intended for informational purposes only. It does not constitute medical advice. Always consult a qualified healthcare provider before starting, stopping, or adjusting any medication.

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