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In late 2022, pharmacist Joseph Lambson received an unexpected call from a poison control expert discussing concerns related to semaglutide, an active ingredient in popular diabetes and weight-loss medications Ozempic and Wegovy. The specialist noted that individuals were reportedly giving themselves doses ten times higher than recommended. Considering that these medications come in prefilled injector pens designed to eliminate dosing errors, the situation raised a red flag for Lambson.
As a board-certified toxicologist, Lambson quickly deduced that the issue likely stemmed from compounded forms of semaglutide. Investigations by his team at the Utah Poison Control Center confirmed this, revealing that overdoses were occurring due to patients misusing compounded forms of the drug, resulting in symptoms such as severe nausea, vomiting, and diarrhea.
Both Ozempic and Wegovy have faced significant supply issues, being listed on the U.S. Food and Drug Administration’s (FDA) drug shortage list since 2022. This shortage created a vacuum that online sellers rushed to fill, with some supplying compounded versions of the drug. Compounding pharmacies can create drug formulations tailored to specific patient needs, but with shortages in legitimate medications, risks have increased as patients may not fully understand how to administer these compounded products correctly.
Lambson described cases where patients mistakenly injected excessive amounts of semaglutide due to confusion over instructions. Research published in Clinical Toxicology highlighted incidents of individuals administering doses drastically exceeding the recommended levels, often based on misinterpretations of their treatment regimens.
Semaglutide acts as a GLP-1 receptor agonist, a class of medications that can aid in weight loss and improve metabolic health. While these drugs can offer significant benefits, they can also produce serious side effects. For patients who have to self-dose with a syringe, the risks of errors magnify. Compounding pharmacies must adhere to regulations, but without consistent oversight, the safety and efficacy of compounded drugs can be problematic.
In early 2024, the FDA removed semaglutide from its shortage list, and updates about tirzepatide—a similar GLP-1 medication—indicated that it too was being phased out of shortage status. However, the easing of supply issues does not guarantee affordability or accessibility for all patients. Many insurance plans restrict coverage for such medications, leaving those without coverage to face exorbitant costs.
The financial burden of GLP-1 drugs often drives patients toward less reliable sources for medication. Experts express concern that individuals may turn to unverified online sellers offering GLP-1 drugs purportedly for “research only.” These vendors often operate without the oversight typical of licensed pharmacies, posing potential health risks as patients self-administer without professional guidance.
The switch to these unregulated alternatives can lead to confusion and potential health hazards. The reconstitution process for powdered forms of semaglutide or tirzepatide necessitates a careful approach to ensure safe dosing. Improperly mixed drugs could lead to serious adverse effects, heightening the risks for patients.
Despite these concerns, many individuals experience life-changing benefits from GLP-1 drugs. Case studies, such as that of a woman named Melanie, highlight how compounded tirzepatide offered her relief from weight-related health issues. After struggling with various unhelpful diets and therapies, she reported significant weight loss and improvements in her overall well-being after starting on tirzepatide, sharing that she feels healthier now than she did in her forties.
However, Melanie’s situation illustrates the rising concern among patients who may soon lose access to compounded options. As Mel’s health has vastly improved thanks to the medication, she worries about the future and the absence of alternatives should her compounding pharmacy stop supplying the drug.
The clinical benefits of GLP-1 medications include not only weight loss but also broader health implications, such as reduced risks of cardiovascular events and improved mental health outcomes. Studies have linked use of these medications to decreased incidences of substance abuse disorders and various psychological conditions. Yet the drugs also carry potential gastrointestinal side effects, which can discourage patients, leading to high discontinuation rates among non-diabetic users.
As the situation with compounded drugs unfolds, calls to public health officials and pharmacists emphasize the importance of ensuring patient safety while navigating these complex issues. The increasing activity in poison control centers suggests a growing need for caution among patients opting for compounded medications.
Experts are now observing a trend towards reliance on unverified online suppliers as the primary source of medication. Concerns over the purity and potency of these products prompt warnings from health professionals aimed at minimizing risks associated with self-medicating and improper dosing.
While the landscape of GLP-1 medications continues to evolve, consumers are challenged by navigating options that span from legitimate pharmacies to unregulated online sellers. Proper education about safe practices and medications remains essential as patients strive for effective solutions while facing obstacles in accessibility and affordability.
Source
www.sciencenews.org