Emergency departments do not routinely screen for GLP-1 use. Anesthesia teams flagged it as something that changes their planning back in 2023, but that has not filtered through to every triage desk — which leaves you carrying the information.
Save this page or print it. The four things below matter most, and the second one matters most of all.
Say these four things first
| Tell them | Why it changes their plan |
|---|---|
| The drug and who makes it — “Wegovy, Novo Nordisk”, “Zepbound, Lilly”, or “compounded semaglutide from [pharmacy]” | Separates semaglutide from tirzepatide from liraglutide, and approved product from compounded. They behave differently and are documented differently. |
| When you last injected — the date, roughly the time | The critical one. Semaglutide hangs about roughly seven days; tirzepatide roughly five; liraglutide barely 13 hours. Your stomach may still be emptying slowly days after the last dose, and that governs how you can be sedated. |
| Your current dose, and whether you have recently stepped up | Higher doses and recent increases go with stronger gut effects and greater aspiration risk. |
| When you last ate, and what it was, if it was inside 18 hours | Directly changes the airway plan for anything requiring sedation. Solids and liquids both count. |
Add your other medications — insulin and sulfonylureas above all, then levothyroxine, warfarin, anti-epileptics, digoxin, and any oral contraceptive.
Common reasons people arrive
- Vomiting and dehydration. The labels record kidney injury in exactly this situation. Expect bloods, fluids and something for the nausea; ask that kidney function is rechecked before you are sent home.
- Severe abdominal pain. Pancreatitis is a labeled risk and worth excluding. Pain under the right ribs with fever or yellowing points instead at the gallbladder, which rapid weight loss makes more likely.
- Anything needing sedation. Tell the anesthesia team about the drug before anything is given. There is published guidance on holds, on clear-liquid preparation, and on when to treat you as having a full stomach.
- Low blood sugar. These drugs rarely do this alone. With insulin or a sulfonylurea they very much can. Ask for a fingerstick and for those doses to be reviewed before discharge.
- Chest pain. Nothing changes. ECG, troponin, the usual pathway. Being on a GLP-1 is no reason to slow any of that down.
If you need an operation
- Planned surgery: the guidance holds daily drugs on the day and weekly drugs for a week beforehand. The 2024 multi-society update softened this for lower-risk patients, adding a day of clear liquids for higher-risk ones who continue. Ask which version your team follows.
- Emergency surgery goes ahead. A GLP-1 is never a reason to delay. The team manages the risk with full-stomach precautions instead.
- Ultrasound can settle it. Scanning the stomach at the bedside to see what is actually in it is increasingly used, and can override a calendar rule in either direction.
- Local or regional anesthesia needs no hold at all.
Things staff sometimes get wrong
- The sulfonylurea outlasts the visit. A dose of glipizide or glimepiride is still working even if the GLP-1 was held. Glucose needs rechecking rather than one reassuring reading.
- The thyroid warning is rodent data. It is not a reason to refuse you a neck ultrasound or any other imaging. Whether it applies to humans has never been established.
- Nothing about a GLP-1 changes stroke or heart-attack care. Do not let it become a reason for delay in time-critical treatment.
- Feeling full and bloated is usually the drug, not gastroparesis — especially just after a dose increase. Persistent or severe symptoms still deserve investigation.
- Compounded products are not the approved drug. Strength and identity are not guaranteed, so bring the pharmacy name, the batch and the concentration if that is what you are on.
What to take with you
- The pen, box or pharmacy label — drug, dose, prescriber.
- A list of everything else you take, supplements included.
- Recent bloods if you have them, especially kidney function, and your last A1C if you have diabetes.
- Insurance details and your prescriber's contact.
- The date and time of your last dose, written down — because remembering it accurately while unwell is exactly what does not happen.
What this does not cover
General adult medical emergencies. Psychiatric presentations are unchanged by GLP-1 status, children follow different airway and fluid rules, and planned surgical clearance is its own pathway.
Where to go next
- Sick-day guide — how to avoid the visit in the first place.
- Diabetes medication interactions — the hypoglycemia picture.
- Contraindications and cautions — what the label actually forbids.
- All cheat sheets — the full reference library.