As injectable weight loss drugs rise in popularity, so does unintended misuse

As weight loss medications continue to grow in popularity, the Illinois Poison Center is seeing more calls from people misusing or dosing the medications incorrectly.

We’re definitely seeing the trend, said Matt Novak, a trained pharmacist and certified poison information specialist. We’ve had a few situations where people are giving themselves 10 times the amount they’re supposed to be taking.

The Illinois Poison Center received 61 calls in 2022. In 2023, that number nearly doubled to 121. With 35 calls in the first quarter of 2024, the calls are on pace to surpass this year.

You know, I think more people are taking these drugs, said Dr. Michael Wahl, medical director of the Illinois Poison Center. Wahl said some people can get confused by the injection pens used to administer the medication.

Suppose they should take 0.25 milligrams, but they misplace it in the pen and take 1 milligram or 4 milligrams. They can take large doses, make huge dosing errors, which can then lead to nausea, vomiting, diarrhea, dizziness, and that’s when they call us, Wahl said.

Tony Simon is an attorney who represents at least 25 people in Illinois with another concern.

Some of my clients who were taking the drug had serious complications that they were never told about, Simon said.

Simon has filed several lawsuits in Illinois against Novo Nordisk, the maker of Ozempic, alleging the drug maker failed to warn about potential complications, including stomach paralysis.

If there is an adequate warning on the label by the manufacturer of the risks he became aware of during his clinical trials, by putting it on the label and entering it in the information, that doctor and his patient can judge properly whether or not they want to do it. that, said Simon.

Novo Nordisk responded to the Illinois lawsuits with the following statement:

Novo Nordisk believes that the allegations in these lawsuits are without merit, and we intend to vigorously defend against these claims. Patient safety is our highest priority at Novo Nordisk and we work closely with the US Food and Drug Administration to continuously monitor the safety profile of our medicines. GLP-1 drugs have been used to treat type 2 diabetes (T2D) for more than 18 years and to treat obesity for 8 years. This includes Novo Nordisk GLP-1 products such as semaglutide and liraglutide that have been on the market for over 13 years. Semaglutide has been extensively examined in robust clinical development programs, large real-world evidence studies, and has accumulated more than 9.5 million patient years of clinical experience. The known risks and benefits of semaglutide and liraglutide medications are described in the FDA-approved product labeling. Novo Nordisk guarantees the safety and effectiveness of all our GLP-1 medicines when used as directed and when taken under the care of a licensed healthcare professional.

Rita Glaze-Rowe is the president of Transformative Healthcare Markets for Real Chemistry, a healthcare innovation company with an office based in Chicago.

People can’t, don’t want to wait until they can find a doctor, Glaze-Rowe said.

Demand is so high that it’s creating shortages of some drugs, with the FDA reporting limited availability for Mounjaro, Zepbound and Wegovy.

So what we’re seeing is people moving out of the health care system, Glaze-Rowe said.

Real Chemistry is tracking the unprecedented rise of what they call GLP-1 influencers, posting on social media about their experience and driving people to medical spas, telehealth providers and compounding pharmacies.

We were seeing that it was, I can get you your semaglutide tomorrow. Now what we’re seeing is a little bit of a difference that says it’s the same active ingredient as, Glaze-Rowe said.

While combination formulas of FDA-approved weight loss medications may be easier to access and cheaper, Dr. Naomi Parrella offered this caveat.

Compounding pharmacies don’t ship the same medications you get from a regular drug company. So the problem is that it is not regulated. So we don’t really know the safety profile, said Parrella, chief of lifestyle medicine at RUSH University Medical Center.

The FDA has been very clear on this. These medications should not be purchased in a compounded formula, Parrella said.

A trained pharmacist, Matt Novak has fielded phone calls to the Illinois Poison Center from people taking compounded versions.

They’re sent a vial and a syringe and patients aren’t properly trained and administered because it’s all online, Novak said. They get confused and draw the whole vial.

The key is to make sure you start any medication to get all the information ahead of time and know how to take it safely, Parrella said.