The Medicines and Healthcare Products Regulatory Agency (MHRA) is advising medical practitioners to make sure patients are informed about the known adverse effects of agonists of the glucagon-like peptide-1 (GLP-1) receptor. These medicines are used to treat type 2 diabetes or obesity, with the common risk of gastrointestinal side effects which may affect more than 1 in 10 patients. While most side effects for these medicines are mild, some may also be serious.
Healthcare professionals should also be alert for signs of misuse of these medicines in their patients, warn these patients that they are at risk of side effects and report any adverse reactions via the Yellow Card scheme.
GLP-1 receptor agonists approved for weight management, are effective treatment options for patients with a Body Mass Index (BMI) higher or equal to 30 kg/m2 or for patients whose BMI is higher or equal to 27 kg/m2 and have a weight-related medical condition, such as cardiovascular disease. GLP-1 receptor agonists can only be prescribed by a registered healthcare professional. When appropriately used in line with the product license, the benefits of these medications outweigh the risks for patients. However, this benefit-risk balance is positive only for those patients within the approved indications for weight management or type 2 diabetes as described in the product information.
If patients obtain a private prescription (from a non-NHS prescriber), they should ensure this is dispensed from an authorized source, such as a registered pharmacy, to avoid the risk of receiving a falsified pen. They should be aware that some falsified medicines have been found to contain insulin, which if used, could cause severe hypoglycaemia (low blood sugar) requiring urgent medical attention.
It is vital for patients to carefully read the instructions in the Patient Information Leaflet and use the prescribed dose. Potential side effects of these medicines can include gastrointestinal conditions, such as vomiting and diarrhoea. In most cases, these are not usually serious, but may sometimes lead to more serious complications such as severe dehydration, resulting in hospitalisation. Patients are advised to stay hydrated by drinking plenty of fluids throughout treatment. Gastrointestinal side effects are more likely to occur at the start of treatment or after a recent increase in dose. Healthcare professionals should also discuss the risk of serious, but less common side effects such as pancreatitis and gall bladder disorders. Hypoglycaemia (low blood sugar) can occur in non-diabetic patients using some GLP-1 receptor agonists for weight management and healthcare professionals should ensure patients are aware of the symptoms and signs of this condition, such as sweating, shaking, feelings of tiredness or weakness and confusion. Where this occurs, patients should eat or drink something that will raise their blood sugar quickly, and if symptoms persist they should seek medical attention. Patients prescribed GLP-1 receptor agonists should speak to a healthcare professional if they have any questions about potential side effects.
Healthcare professionals should consult our Drug Safety Update for further advice.
