Dealing with GI Side Effects from GLP-1 Drugs

by admin  - 
Dealing with GI Side Effects from GLP-1 Drugs

Opinion Piece: Josh Fink, MD

 

So, you are having some GI [“Gastrointestinal”] side effects on a GLP-1 drug.  First thing, when I say “GLP-1” drugs, I mean drugs like Ozempic, Wegovy Zepbound…even though Zepbound is more than just a GLP-1 drug, s it works on more than one receptor in the body. The good news that that many of th GI side-effects are “time-limited” and may resolve after several weeks. The second pice of good news is that most of these problems are “mild to moderate” and not severe. Here are some practical tips to deal with some of the GI side effects you can see with the weight loss drugs, such as Wegovy or Zepbound:

  1. Eat smaller meals and eat slowly.
  2. Do not lay down right after eating.
  3. Foods that are higher in fiber can cause more distress. Lower the fiber content and re-introduce as tolerated.
  4. Try to seperate your fluid intake from your solid food intake. Drink your fluids either 30 minutes before or 30 minutes after your meal.
  5. Avoid artificial sweeteners, as these can cause stomach distress.

Sometimes, these simply changes work. Other times, a change in the dosing might be needed. You might have to go back “one step” to a lower dose of the medicine for the next scheduled injection, and that might occur only once after the GI symptoms have resolved. Sometimes, it may mean switching to another medication. Although these side effects are thought to be “rather the same” across these types of drugs, real-world evidence suggest that they may be slightly different.

   For nausea, one medication that can be used is Domperidone {10–20 mg three to four times daily} should be used rather than metoclopramide, especially in older patients, to minimize some of the side effects.  Domperidone can have cardiac side-effects, so your doctor may need to check an EKG. If the drugs prescribed to improve nausea (or other GI side effects) are needed for over a month when your maintenance dose of he GLP-1 has been reached, a dose reduction may need to be considered.
   For vomiting, which is fortunately less common than nausea, medication might occasionally be needed as well. If vomiting persists, it is important to reach out to the doctor.
   If diarrhea occurs, and you are on metformin, the dose of metformin may need to be changed, especially if you are on a PPI medicine, like Prilosec or Protonix.
     If your stomach issues are feeling severe, it is important that you reach out to your doctor or visit the nearest emergency room to be sure that it is not something more serious that might need immediate attention.
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Disclaimer:  The above post is for general information use only and cannot be guaranteed to be accurate. No doctor-patient relationship exists be reading or interacting with this post. Do not make any personal medical decisions by reading this information, and any medical decisions you make must strictly be between you and your health care provider.