January 8, 2025

Saanvi Sharma 

10th Grade

Williamsville East High School

Introduction

Ozempic for Weight Loss

According to the Centers for Disease Control and Prevention (CDC), about 42% of American adults are obese, which means they have a BMI of over thirty. Obesity is calculated through body mass index (BMI), which measures a person’s height in relation to their weight. 

Like any medical condition, there are different ways to manage obesity. This can include many different weight-loss medications. Again, Ozempic has not yet been approved for weight loss. However, semaglutide (Ozempics generic name) is approved for weight loss under the name Wegovy. Ozempic has a smaller dose of semaglutide than Wegovy.

Ozempic can help people lose weight, however, experts recommend that people avoid using Ozempic for weight loss since it is meant for people with type 2 diabetes. As per the FDA, there are no approved generic versions of these drugs. Regardless, an off-brand version of the drug has been seen at compounding pharmacies across the U.S., which led to the FDA receiving reports of adverse events after patients used these generic versions of semaglutide.

Poison Control Concerns

In 2023, poison control centers across the country reported nearly 3,000 calls related to semaglutide. That is a 1,500% increase in calls since 2019, according to America’s Poison Centers. This increase is mainly due to the drug's increase in popularity for its weight loss component.

To cite the examples, there were three cases of adverse drug events after incorrect administration of semaglutide for weight loss obtained from compounding pharmacies and an aesthetic spa. Two patients self-administered 10-fold dosing errors. All patients experienced notable symptoms of nausea, vomiting, and abdominal pain with most symptoms lasting for days. Other symptoms of headache, anorexia, weakness, and fatigue were reported in one patient. Another patient sought evaluation at a healthcare facility and responded well to antiemetic and intravenous fluids. One patient who received their medication from a compounding pharmacy reported receiving a vial with syringes for self-administration; no pharmacist counseling was provided on proper drug administration. In another case, a patient reported dosing in milliliters and units rather than milligrams. 

These three semaglutide cases highlight the potential for patient harm given current practices. Vials of compounded semaglutide do not use safety features provided by prefilled manufactured pens and allow for large overdoses (e.g., 10-fold dosing errors). Use of syringes not intended for semaglutide contributes to the variability of dosing units (milliliters, units, milligrams), contributing to patient confusion. Increased vigilance in labeling, dispensing, and counseling practices will ensure patients are confident in administering their medication regardless of the formulation. Such vigilance and promotion could decrease the risk of more severe adverse drug events and avoidable hospital utilization that may arise from dosing errors.

The Data Behind Concerns 

There have been nearly 3,000 reports about semaglutide exposure in 2023, at least fifteen times more than in 2019. There were 2,941 reports of semaglutide exposure reported to poison control centers in the US in 2023, up from 196 reports in 2019.

The US Food and Drug Administration first reported a shortage of semaglutide in March 2022, opening the market up to compounded versions of the drug that may require the patient to measure their own doses. 

“Oftentimes a person who maybe accidentally took a double dose or took the wrong dose,” says Kait Brown, PharmD, clinical managing director of Americas Poison Centers. Patients were hospitalized due to severe nausea, vomiting, and stomach pain, according to the reports. Officials at state poison centers believe compounded versions of semaglutide may be behind many of the calls, but reported symptoms do not enable them to say with certainty whether the surge stems from Ozempic and Wegovy, which are approved products, or compounded versions.

Symptoms and Treatment 

Signs of a semaglutide overdose include feeling lightheaded, dizzy, shaky, or jittery. Sweating, chills, clamminess, irritability, impatience, headache, weakness, fatigue, nausea, vomiting, seizures, confusion and passing out. What makes it more dangerous is the fact that there’s no specific antidote for semaglutide overdose. The drug has a half-life of about a week, meaning it takes one week to clear half of it from your body. Emergency departments and hospitals can only help support patients with intravenous fluids and anti-nausea drugs as the drug works its way out of their bodies.

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

Name-brand drugs are sold in pre-filled pens with some safeguards to keep patients from making mistakes with their dosages. Compounded versions, which the FDA does not review for safety or effectiveness, typically require patients to draw their own doses from glass vials into syringes.

It’s important that the general public is properly informed of ozempic and its side effects, as it is not the magic weight loss drug many believe it to be. The correct administration of the drug by pharmacies and clear instructions on dosage will allow patients to utilize semaglutide safely. Proper knowledge on how to manage weight loss in a healthy manner, and the consequences of ozempic and its generic drugs, will help stop the ozempic crisis.