Daijiworld Media Network – New York

New York, May 6: While GLP-1 receptor agonists (GLP-1 RAs) are gaining widespread use for diabetes and weight management due to their added health benefits, experts have flagged growing concerns over side effects and potential drug interactions.

These medications, known for improving glycaemic control and aiding weight loss, are also associated with several gastrointestinal side effects such as nausea, vomiting, abdominal pain, diarrhoea, constipation, bloating and flatulence. Other risks include hypoglycaemia when used alongside other antidiabetic drugs, gallstone formation, rare cases of pancreatitis, and possible loss of muscle and bone mass.

Studies have also highlighted issues such as treatment discontinuation rates of 4–8 per cent, weight regain after stopping the drug, and high costs, raising questions about long-term sustainability.

Experts note that long-term data on safety and effectiveness remain limited, particularly regarding bone health, fracture risk, and other adverse outcomes.

A key concern that has gained attention is the potential for drug interactions. GLP-1 RAs can delay gastric emptying, which may affect the absorption and effectiveness of other oral medications.

Significant interactions have been observed with certain drugs. Tirzepatide has been shown to alter levels of oral contraceptives, while oral semaglutide may impact levothyroxine levels. When combined with insulin or sulfonylureas, the risk of hypoglycaemia increases, requiring dose adjustments.

Additionally, experts advise discontinuing dipeptidyl peptidase-4 inhibitors when initiating GLP-1 therapy, as both act on similar pathways. There are also concerns that GLP-1 RAs may significantly increase levels of dabigatran, potentially raising bleeding risk.

However, no major clinically relevant changes have been observed with drugs such as warfarin, digoxin, lisinopril, metformin, atorvastatin and paracetamol, despite minor variations in absorption patterns.

Medical experts emphasise the need for further research to better understand these interactions and ensure safer use, especially for patients taking medications with narrow therapeutic ranges.

They caution that unmonitored use could lead to serious consequences, including contraceptive failure, hypoglycaemia, bleeding risks, or reduced effectiveness of treatments for thyroid disorders and infections.