Preoperative Management of Patients Taking Ozempic or Mounjaro
General
Ozempic (semaglutide) and Mounjaro (tirzepatide) are once-weekly injectable medications used primarily to manage type 2 diabetes and for weight loss. They act by mimicking gut hormones (GLP-1 for Ozempic; GLP-1 and GIP for Mounjaro), improving insulin secretion, reducing glucagon levels, slowing gastric emptying, and reducing appetite.
Special Care is Needed Before Surgery
These medications delay stomach emptying, increasing the risk of regurgitation and aspiration during anaesthesia or sedation — a potentially life-threatening complication.
Recommendations for Perioperative Management
Withhold Ozempic & Mounjaro for at least 1 week before elective procedures with GA or sedation
For daily GLP-1 agonists (e.g., liraglutide/Saxenda/Victoza): hold the day before surgery.
Preoperative Fasting and "Sip Til Send"
Patients should follow standard fasting protocols, with clear fluids allowed until 2 hours before anaesthesia, unless high aspiration risk is suspected.
"Sip til Send" protocols (per local guidelines) may need to be modified or withheld if the patient has not stopped GLP-1 agonists as recommended.
Key Notes for Anaesthetists and Surgical Teams
Always ask about GLP-1 receptor agonists during preoperative assessment.
If the medication has not been withheld, the patient may be treated as having a full stomach.
- Consider delaying elective procedures.
- Use rapid sequence induction if urgent surgery is needed.
Patients should resume medication postoperatively once eating and drinking normally.