Accidental overdoses from ‘copies’ of the weight-loss drug sold commercially as Ozempic and Wegovy are becoming more prevalent in the United States. The Food and Drug Administration (FDA) has recently issued a warning to patients, health providers, and compounding pharmacies due to a rise in dosing mistakes related to injectable semaglutide. Symptoms of these overdoses can vary and include nausea, vomiting, fainting, migraine, dehydration, pancreatitis, and gallstones. In severe cases, overdoses can even lead to hospitalization. At the end of last year, America’s Poison Centers reported receiving 15 times more calls related to semaglutide compared to 2019.
Semaglutide injections were initially approved by the FDA to treat diabetes but have gained popularity in recent years due to their rapid weight loss effects. The surge in demand for semaglutide medications has led to a shortage of FDA-approved injections, creating an opportunity for unapproved ‘copies’ of the drug known as compounded drugs to enter the market. When compounded, semaglutide can have varying concentrations from vial to vial, leading to dosing errors. Compounded drugs are mixed by licensed pharmacists or at drug facilities, with some patients being instructed to administer semaglutide in ‘units’ while others receive dosages in milligrams or milliliters.
Reports received by the FDA have indicated that many patients are mistakenly drawing up more than the prescribed dose from a multiple-dose vial during self-administration. Patients have administered significantly higher doses, ranging from five to twenty times more than the intended amount. The majority of these incidents were a result of patients being unfamiliar with how to measure the correct dosage using a syringe. In one reported case, a healthcare provider accidentally gave 25 units of semaglutide instead of the intended 0.25 milligrams, resulting in severe vomiting. Another case involved a provider prescribing 20 units instead of 2 units, causing nausea and vomiting in three patients.
To prevent these dosing errors, the FDA recommends that health care providers and compounders provide patients with appropriately sized syringes that cannot be filled beyond the intended dosage. Patients should be carefully instructed on how to measure the correct dosage using a syringe, and healthcare providers must be vigilant in their dosage conversions when prescribing compounded drugs. If an overdose of semaglutide is suspected, immediate medical attention should be sought.
The increasing prevalence of accidental overdoses of ‘copies’ of weight-loss drugs like semaglutide in the US is a cause for concern. Health care providers, pharmacists, and patients must be aware of the risks associated with compounded drugs and take precautions to avoid dosing mistakes. Education and proper guidance on the administration of semaglutide are crucial in preventing potentially harmful overdoses.
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