Do elevated ApoB-containing lipoproteins irritate the vascular lining?

Yes, standard pre-operative guidelines generally advise temporarily stopping Ozempic (semaglutide) before undergoing anesthesia.

What the Guidelines Recommend

The American Society of Anesthesiologists (ASA) updated its consensus guidelines to address the use of GLP-1 receptor agonists, the class of medications to which Ozempic belongs. The current recommendations are:

• For weekly formulations (like Ozempic): Hold the weekly dose prior to the day of the procedure. In practice, this means your last dose should be taken at least 7 days before your scheduled surgery.
• For daily formulations (like Rybelsus): Hold the medication on the morning of the procedure.

Note: Some surgical centers or specific procedures may require a longer hold time (such as 10 to 14 days). Always follow the specific instructions provided by your surgical and anesthesia teams.

Why It Is Important to Stop

Ozempic works by mimicking a hormone that slows down digestion, meaning food stays in your stomach significantly longer. When you undergo general anesthesia or deep sedation, your body's natural reflexes (like swallowing and coughing) are temporarily suspended.

If your stomach is not completely empty:

• There is a high risk of regurgitation.
• This can lead to pulmonary aspiration, where stomach contents or acid enter the lungs.
• Aspiration can cause severe, life-threatening lung infections and respiratory complications.

What You Should Do Next

1. Consult your surgical team: Contact your surgeon and anesthesiologist as soon as possible to confirm their specific protocol for your medication. Do not stop or alter your dosage without their direct guidance.
2. Be honest on the day of surgery: If you accidentally took your Ozempic within the week leading up to your procedure, tell your anesthesia provider immediately. They will not necessarily cancel your surgery; instead, they may use an ultrasound to check if your stomach is empty, adjust the type of anesthesia used, or take extra precautions to protect your airway during the procedure.
3. Resuming the medication: Your healthcare team will advise you on when to restart Ozempic, which is typically once you are able to eat and drink normally after surgery.