Patients have been referred to hospital emergency departments after unintentionally taking a higher dose of Ozempic than prescribed, data obtained by Guardian Australia has revealed.
The drug semaglutide, sold under the brand name Ozempic in Australia, is subsidised under the pharmaceutical benefits scheme for the treatment of type 2 diabetes.
But doctors also prescribe it “off label” for weight loss for those living with obesity, costing those patients more than $130 a month. It is usually administered once a week via an injection pen.
Data from Australia’s largest poisons information centre, in NSW, revealed that, in the year to the end of October 2023, more than 120 calls were made to the centre related to semaglutide.
Of these, 83% were due to medication errors, including an individual taking an incorrect dose, administering the medication incorrectly, or the medication being taken by the wrong person.
Meanwhile the Victorian Poisons Information Centre told Guardian Australia that in the 24 months to the end of October 2023 the service had received 82 calls related to Ozempic or semaglutide.
Seven of these calls led to the caller being referred to an emergency department or urgent care centre for further monitoring, due to complications or adverse effects resulting from unintentionally administering higher doses than prescribed.
But 10% of the calls to the Victorian service were in relation to intentional medication misuse.
“Patients reported to have used friend’s or family member’s medication for the purpose of weight loss, or intentionally used their own prescribed medications at higher doses than prescribed, with the goal of weight loss,” a spokesperson for Austin Health, which manages the service, said.
The primary reason for most (74%) of the calls was unintentional medication administration errors.
Each “pen” of Ozempic contains multiple doses, with one dose taken a week.
“It is not uncommon for a patient to accidentally inject the entire contents in the pen – up to four times the intended dose,” the spokesperson said.
High-profile celebrities and social media influencers touting Ozempic for weight loss triggered a surge in demand and contributed to an ongoing worldwide shortage of the drug, despite warnings about a lack of longterm data around side effects and efficacy.
The ongoing supply shortages in Australia are expected throughout 2024 and doctors are being advised not to write prescriptions for the drug to new patients. Meanwhile pharmacists have been told to prioritise any supply to diabetes patients.
A paper published earlier in 2023 in the Internal Medicine Journal, the journal of the Royal Australasian College of Physicians, found increasing poison centre calls regarding semaglutide are associated with publicity of the drug as being a weight loss agent.
The paper concluded a high number of dosing errors “signals a need for clear dosing advice from prescribers and pharmacists, particularly to patients who may be unfamiliar with injectable dosing devices”.
The supply shortage of semaglutide is a global issue, prompting people to illegally seek out counterfeit versions of the drug. Use of fake semaglutide has been linked with several hospitalisations in Austria, with patients suffering from serious side effects including seizures.
A spokesperson for drugs regulator the Therapeutic Goods Administration (TGA) said counterfeit semaglutide products coming into Australia have been stopped at the border and “not released to the consumer”.
“The TGA is not aware of any of these reported products entering Australia,” the spokesperson said.
“The TGA has not received any Australian reports of adverse events for Ozempic that suggest a counterfeit product was involved.”
