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GLP-1 adverse effect — GPhC CRA MCQ

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HardEndocrine TherapeuticsGLP-1 adverse effectGPhC CRA

A patient using semaglutide develops severe persistent upper-abdominal pain radiating to the back with vomiting. What should the pharmacist advise?

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Correct answer: BStop semaglutide and seek urgent assessment for acute pancreatitis

Stop semaglutide and seek urgent assessment for acute pancreatitis: Severe persistent pain radiating to the back with vomiting is a pancreatitis warning pattern; the UK SmPC requires immediate discontinuation and investigation. Omit one dose and arrange assessment at the routine diabetes appointment: Suspected pancreatitis needs urgent assessment and treatment should not merely be paused until routine review. Reduce semaglutide and add an antiemetic without investigation: Dose reduction and symptom suppression could delay recognition of a serious adverse reaction. Restart semaglutide at the original dose after pain and vomiting have fully resolved: Symptom resolution does not exclude pancreatitis or authorise unreviewed rechallenge. Change immediately to another GLP-1 receptor agonist: A class substitute should not be started before the suspected pancreatitis is assessed and resolved.

Reference: Ozempic UK summary of product characteristics: https://www.medicines.org.uk/emc/product/9750/smpc; BNF: semaglutide: https://bnf.nice.org.uk/drugs/semaglutide/