Can You Overdose on GLP-1s? Poison Control Is Fielding More Calls About Weight Loss Drugs

Poison control center hotlines across the U.S. are receiving calls from people taking injectable drugs for weight management, such as Zepbound and Wegovy.

Some of the centers report they are also receiving calls about Mounjaro and Ozempic, both approved by the Food and Drug Administration (FDA) for diabetes, but both often prescribed by doctors for weight loss.

“Calls to our center have included questions from people about the safety of the drugs before taking their first dose, side effects, and accidentally taking the wrong dose,” Maryann Amirshahi, PharmD, MD, MPH, co-medical director at the National Capital Poison Center in Washington, DC, told Verywell. 

While 2023 data is still pending, Amirshahi said there were 4,413 case records in the National Poison Data System related to GLP-1 receptor agonist drugs, a class of drugs used for type 2 diabetes and weight management. For reference, in 2019, there were 861.

A critical issue some poison centers are flagging is that people using the drugs may not know how to take them. Nearly three-quarters of the 2023 cases were coded as “unintentional therapeutic error.”

“A lot of the time, people do not get adequate teaching about how to use these medications,” Amirshahi said, noting some callers are confused about whether they should take the drug once per day or once per week. (GLP-1 receptor agonist medications like Zepbound and Wegovy are taken weekly.)

Severe Side Effects and Overdose Signs

Amirshani said the most common indicators of an overdose of injectable weight management medication are severe gastrointestinal side effects like nausea, vomiting, and abdominal pain.

“If you are having multiple episodes of vomiting, blood in the vomit, are not keeping anything down, or have severe or persistent abdominal pain, you should call a poison center or seek medical attention,” she said. “Also, while low blood sugar (hypoglycemia) is rare with these medications, if it occurs, you should seek medical attention.”

There’s a fine line between nasty side effects that you can endure at home and issues that require medical attention. According to Joseph Lambson, PharmD, director of the New Mexico Poison and Drug Information Center, symptoms of taking too much of a drug like Wegovy are similar to symptoms experienced at normal therapeutic doses, but more heightened: nausea, vomiting, headache, and dizziness.

When in doubt, just call poison control. Lambson said an expert can help you evaluate your individual situation, including the severity of symptoms, the duration of symptoms, and any existing medical conditions you have.

Amirshahi added that not every adverse experience with a GLP-1 receptor agonist will require a trip to see a medical professional.

“In many cases, people with mild symptoms can be watched at home,” she said. “Sometimes, we will tell them to use a home blood sugar monitor to check their sugar if they have one. We often refer people who have low blood sugar or who can’t keep anything down [to the hospital]. We are also more careful with diabetic patients who are on more than one medication to lower their blood sugar because they are at higher risk of hypoglycemia.”

Compounded Medications Pose Additional Risks

Because there have been widespread shortages of GLP-1 drugs as their demand increases, some patients have turned to local or online compounding pharmacies to access mediation touted as having the “same active ingredient.” Compounded drugs may also be cheaper in the event that insurance doesn’t cover your medication.

Drug compounding involves the mixing of multiple drugs or the alteration of ingredients. People may seek out compounded drugs if there is a shortage of a medication, or if a brand-name drug contains an ingredient, such as a dye, that they are allergic to.

The problem? Compounded drugs are not FDA-approved and, therefore, are not vetted by the FDA for safety and efficacy. In some cases, the compounded version does not contain the same active ingredient as the brand-name drug. The FDA has received reports of compounders using salt forms of semaglutide (the active ingredient in Wegovy and Ozempic) instead of the base form, which is neither safe nor effective.

Lambson recently published a review article about three cases of adverse drug events after incorrect administration of semaglutide that patients received from compounding pharmacies or an aesthetic spa. Two patients gave themselves ten times the dose they should have, and all three of the patients had “notable” symptoms of nausea, vomiting, and abdominal pain for days.

“With compounded formulations, patients have to draw the medication out themselves with a syringe,” Lambson told Verywell. “If they’re unfamiliar with the techniques of how to do this, it can be very easy to give, for example, 0.1 milliliters of a drug instead of 0.01 milliliters.”

Lambson urges patients to stick to the brand name drugs if they can. If their only option is a compounded version because of affordability or availability, “they should discuss with the pharmacist what type of formulation they’re using to see if it matches up with what is an FDA-approved product,” he said.