ISSUE 4 AUGUST
Adapted with permission from Therapeutic Goods Administration (TGA) Medicines Safety Update 3 June 2025.
Summary
Glucagon-like peptide-1 (GLP-1) receptor agonists and dual glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 receptor agonists are relatively new and high-profile classes of medicines that are used to treat type 2 diabetes mellitus, for chronic weight management, and for secondary cardiovascular risk reduction in people with type 2 diabetes or who are overweight (approved indications and doses vary by product – refer to each product’s approved Product Information for details).
The GLP-1 receptor agonists currently marketed in Australia are dulaglutide (Trulicity), liraglutide (Saxenda, Victoza, ARX-Liraglutide) and semaglutide (Ozempic, Wegovy). The only dual GIP/GLP-1 receptor agonist currently marketed in Australia is tirzepatide (Mounjaro).
There is a known potential for all these medicines to delay passage of food through the stomach (gastric emptying). This poses a potential risk for patients during general anaesthesia or deep sedation, as the usual fasting period beforehand may not be sufficient to empty the stomach.
The TGA has required sponsors to update Product Information (PI) and Consumer Medicine Information (CMI) documents for all of these medicines with a warning about the risk of accidentally inhaling (aspirating) stomach contents during general anaesthesia or deep sedation.
What health professionals should do
Be alert to the class-wide warning being added to the PIs for these medicines about the risk of pulmonary aspiration during general anaesthesia or deep sedation.
Advise patients of the risk and to alert their health professionals, including anaesthetists, that they are taking one of these medicines before a surgical procedure, to ensure appropriate management.
Anaesthetists should:
- be particularly alert that residual gastric contents may remain despite preoperative fasting in patients taking these medicines
- ask patients whether they are taking one of these medicines
- consider the risk of aspiration in patients taking these medicines within the preoperative risk assessment, so it can be managed appropriately.
Information for consumers
Patients are advised to tell health professionals, including anaesthetists, that they are taking one of these medicines before a surgery or other procedures.
See the full article on the TGA website.
