MHRA Alert – GLP-1 Agonists and Pulmonary Aspiration Risk During Anaesthesia

MHRA Drug Safety Update

Healthcare professionals should be aware of a potential risk of pulmonary aspiration in patients taking GLP-1 or dual GIP/GLP-1 receptor agonists who undergo surgery or procedures requiring general anaesthesia or deep sedation.

What You Need to Know

GLP-1 and GIP/GLP-1 receptor agonists are associated with delayed gastric emptying. This mechanism, while therapeutically beneficial for weight and glucose management, may increase the risk of pulmonary aspiration of gastric contents during anaesthesia or deep sedation—a serious perioperative complication.

Affected Medications

This alert applies to:

• GLP-1 receptor agonists: semaglutide, liraglutide, dulaglutide, exenatide, and others in this class
• Dual GIP/GLP-1 receptor agonists: tirzepatide, and other agents in development or recently approved

Recommended Actions

• Review medication histories for all patients presenting for elective surgery or procedures under general anaesthesia or deep sedation
• Discuss GLP-1/GIP-GLP-1 use with patients preoperatively and document clearly
• Consider perioperative fasting guidance and timing of the last dose in consultation with anaesthetic colleagues
• Apply standard aspiration precautions and ensure appropriate airway management
• Report any suspected adverse reactions via the Yellow Card scheme

Further Information

For the full MHRA drug safety update, visit the MHRA website.