A new study from a poison control center in Alabama offers a reassuring perspective on the rising number of calls related to popular GLP-1 receptor agonists, such as Ozempic and Wegovy. While exposures to these medications have increased significantly over the past two decades, the research suggests many cases are accidental, associated with mild symptoms, and rarely lead to serious health complications.
The study, “GLP-1 Receptor Agonist Exposures Are Increasingly Common and Generally Associated With Mild Symptoms: A Single Poison Center Experience” published in The Journal of Medical Toxicology, analyzed 152 cases reported to the Alabama Poison Control Information Center between 2006 and 2023. Researchers pulled patient demographics, exposure circumstances, and outcomes from the charts and found that a staggering 91% of these exposures were not intentional overdoses but rather a result of therapeutic or administration errors. A primary culprit, the authors note: patient confusion over how to properly use the pre-filled injection pens.
“A common reason for this error was confusion surrounding how to use pen devices by which these agents are administered,” the study’s authors write. Patients often believed the pen had malfunctioned after the initial dose, leading them to accidentally administer a second dose before realizing their mistake. This issue alone accounted for 21% of all exposures, highlighting a critical gap in patient education.
The clinical effects reported by patients were largely non-life-threatening. The most common symptoms were gastrointestinal, including nausea, vomiting, and abdominal pain, along with generalized weakness. In a positive finding, most patients — 62% — were able to be safely managed and monitored at home, avoiding the need for hospitalization.
Patients often believed the pen had malfunctioned after the initial dose, leading them to accidentally administer a second dose before realizing their mistake. This issue alone accounted for 21% of all exposures, highlighting a critical gap in patient education.
The research also tackles a major concern surrounding these medications: hypoglycemia, or dangerously low blood sugar. The study found this serious side effect to be exceptionally rare. It was reported in only two patients who were taking a GLP-1 agonist alone and in two other patients who were also co-administering insulin, suggesting that GLP-1s on their own pose a minimal risk of severe blood sugar drops.
The study’s conclusion points to a clear need for better training at the point of dispensing. With millions of new users unfamiliar with self-injecting medications, the researchers argue that pharmacists and healthcare providers should provide more thorough counseling on pen usage. This simple step could dramatically reduce the rate of therapeutic errors and the subsequent calls to poison control, ensuring patients can safely and effectively use these life-changing drugs.
The authors also suggest that improvements could be made to the pen devices.“Opportunity exists to improve how many of these agents are supplied,” the authors write. “Providing multi-dose pens and vials may increase the risk for a medication error to occur.” The findings provide valuable data for healthcare providers and patients alike, reinforcing that while caution is necessary, the risks associated with accidental exposure are generally mild.
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