ED visits for semaglutide adverse events rare, study suggests
The majority of ED visits related to taking semaglutide were attributed to gastrointestinal complications and hypoglycemia.
There were fewer than four ED visits for adverse events per 1,000 patients dispensed semaglutide in 2023, an analysis of more than 20,000 visits found.
Researchers analyzed data from The National Electronic Injury Surveillance System-Cooperative Adverse Drug Event Surveillance (NEISS-CADES) project, which included 82 hospitals. All reported adverse events were among adults ages 18 years and older who were taking semaglutide between January 2022 and December 2023. Results were published by Annals of Internal Medicine on April 8.
There were a total of 551 cases in the database, which researchers extrapolated to 24,499 ED visits (95% CI, 17,022 to 31,976) due to semaglutide adverse events. Of these, 82.6% occurred in 2023. Average patient age was 50.9 years, and 73.2% were female. In 81.7% of cases, semaglutide was the only medication implicated, and it was nearly always in injectable form (94.0%). Nine percent of ED visits included medication errors.
ED visits most commonly involved gastrointestinal effects (69.3%), hypoglycemia (16.5%), and allergic reactions (5.5%). Nausea/vomiting (57.6%), abdominal pain (25.1%), and diarrhea (12.2%) were the most commonly reported gastrointestinal symptoms. A total of 37.6% (95% CI, 23.7% to 51.4%) of ED visits required hospitalization for hypoglycemia and 15.0% (95% CI, 9.4% to 20.6%) required hospitalization for gastrointestinal effects. Of the 551 cases, six patients were diagnosed with pancreatitis and four with semaglutide-attributed biliary disease. In 21 of 111 cases (18.9%) involving hypoglycemia, semaglutide was implicated alone, without other documented antidiabetic medications.
Limitations to the study include that implicated drugs were identified based on clinicians' documentation and that comorbid conditions and indication for semaglutide use were not systematically collected.
“Given these findings, clinicians could counsel patients when initiating semaglutide about the potential for severe gastrointestinal adverse effects and adjust coprescribed antidiabetic medications to decrease hypoglycemia risk,” the authors wrote. “Additionally, when evaluating patients with new-onset gastrointestinal symptoms or hypoglycemia, clinicians could consider recent semaglutide use,” they concluded.