Guides / Safety and status

Do you need to stop a GLP-1 before surgery?

Not always. The rules changed in 2024, the labels don't give a stop date, and the decision sits with the people doing your procedure.

By PeptideTracker editorial team · Updated November 8, 2026 · 10 sources

[00] Short answer

  1. Every GLP-1 label warns that slower stomach emptying can lead to food or liquid getting into the lungs (pulmonary aspiration) during general anesthesia or deep sedation1,3.
  2. The US labels say the data are not enough to recommend a fasting change or a break from the medicine. They say to tell your healthcare providers before any planned surgery1–4.
  3. The 2024 multi-society guidance (ASA, AGA, ASMBS, ISPCOP, SAGES) says GLP-1s may be continued in people without raised risk. If one is held, it suggests the day of surgery for daily drugs and 1 week before for weekly ones5.
  4. For people at higher risk, that guidance suggests a 24-hour liquid diet before the procedure5.
  5. UK: the MHRA says to take your medicine as usual and not stop without first talking to your doctor8.

What do GLP-1 labels say about anesthesia and surgery?

Wegovy, Ozempic, Zepbound and Mounjaro all carry a warning called "Pulmonary Aspiration During General Anesthesia or Deep Sedation"1–4. The wording is the same on each. From the Zepbound label3:

"There have been rare postmarketing reports of pulmonary aspiration in patients receiving GLP-1 receptor agonists undergoing elective surgeries or procedures requiring general anesthesia or deep sedation who had residual gastric contents despite reported adherence to preoperative fasting recommendations."

In plain words: some people who fasted as told still had food in their stomach, and some of it went into their lungs. The labels then say "available data are insufficient" to recommend a change to fasting, or a pause in the medicine1–4. What they do ask is that you tell your healthcare providers you take it before any planned surgery or procedure1–4.

The UK SmPCs say the "increased risk of residual gastric content due to delayed gastric emptying" should be considered before procedures with general anaesthesia or deep sedation9.

Should you stop Ozempic, Wegovy or Mounjaro a week before surgery?

Not as a rule any more. In 2023 the American Society of Anesthesiologists (ASA) suggested holding weekly GLP-1s for a week before surgery and daily ones on the day7. In October 2024, five societies including the ASA published joint guidance saying most people can keep taking them5–6.

What each source says about GLP-1s before surgery or sedation
SourceContinue or hold?Other points
US labels (2026)1,3No recommendation. Data are insufficientTell your healthcare providers before any planned surgery or procedure
ASA consensus guidance (June 2023)7Consider holding daily GLP-1s on the day, and weekly GLP-1s a week beforeWith severe nausea, vomiting, bloating or stomach pain on the day, consider delaying an elective procedure
Multi-society guidance (2024)5May be continued without raised risk. If held: day of surgery (daily) or a week before (weekly)Decision shared between you and your procedure, anesthesia and prescribing teams. Liquid diet for 24 hours if risk is raised
MHRA, UK (January 2025)8Take as usual. Don't stop without first talking to your doctorYour anaesthetist makes an individual assessment. Pre-procedure instructions or technique may change

The 2024 paper says plainly that "the duration to hold therapy is unknown". The 1-week and day-of times are its suggestion only for people where holding is chosen5.

Who is at higher risk of aspiration on a GLP-1?

The 2024 multi-society guidance lists five things that raise the chance of slow stomach emptying and aspiration5:

  1. Being in the dose-increase (escalation) phase rather than on a steady dose
  2. A higher dose
  3. Weekly rather than daily medicines
  4. Stomach symptoms such as nausea, vomiting, stomach pain, indigestion or constipation
  5. Other conditions that slow the stomach, such as gastroparesis, bowel motility problems or Parkinson's disease

The ASA's press release on that guidance said the escalation phase typically lasts 4 to 8 weeks, and that elective surgery should wait until it has passed and stomach side effects have settled6. The UK MHRA lists gastroparesis, obesity, reflux and symptoms like nausea, vomiting and stomach pain as reasons the risk may be higher8.

The guidance asks for this check to happen early enough before surgery that care can be adjusted5.

What can the surgical team do instead of stopping the GLP-1?

The 2024 guidance lists three main options5:

  • A liquid diet for at least 24 hours before the procedure, as is already done before colonoscopy and weight-loss surgery.
  • A stomach ultrasound on the day (point-of-care gastric ultrasound) to check for food, where the hospital has it.
  • A different anesthesia plan, called rapid sequence induction, which places a breathing tube quickly to lower aspiration risk. Cancelling is the other choice if food is found.

The guidance also says stopping the medicine has its own risks, such as high blood sugar in people with diabetes, and that holding it only for people with obesity "could constitute overweight and obesity bias"5. The 2023 ASA guidance said that if a diabetes GLP-1 is held longer than one dosing interval, an endocrinologist may be needed to manage blood sugar7.

How common is aspiration with GLP-1s?

The labels call the reports "rare"1,3. A 2026 UK study of 47,039 adults having anaesthesia at 119 hospitals found regurgitation or aspiration in 19 of 1,348 people on GLP-1s (1.41%, about 1 in 71). In people not on a GLP-1 it was 57 of 45,691 (0.12%, about 1 in 802)10.

That study observed patients rather than testing the drug, so it shows a link, not proof that GLP-1s caused the events. It also found that how hospitals managed GLP-1s before surgery varied a lot, and most events happened while people were waking up10.

What to tell your surgeon or anesthetist

Tell them you take a GLP-1. Every label and the MHRA ask for this1,3,8. It helps to name the medicine, your dose and the day you inject. The MHRA notes that private prescriptions may not show up in your medical records, so you may need to mention it yourself8.

  • Say whether you're still increasing your dose, and when you last went up.
  • Mention any nausea, vomiting, bloating or stomach pain, especially on the day.
  • Ask what they want you to do with your dose and your diet before the procedure.

If your team asks you to skip a dose, the missed-dose rules and restarting guide show what each label says about picking back up.

Questions

Do I have to stop Ozempic before surgery?

Not necessarily. The 2024 multi-society guidance says GLP-1s may be continued in people without raised risk. The Ozempic label gives no stop date and asks you to tell your providers. Your surgical team decides.

How long before surgery should I stop Mounjaro or Zepbound?

The labels don't say. If a team decides to hold a weekly GLP-1, the 2024 guidance suggests stopping a week before. It also says the right length of time is unknown.

Do I need to stop Wegovy before a colonoscopy or endoscopy?

Deep sedation is covered by the same label warning. The 2024 guidance, which includes the gastroenterology society AGA, applies to endoscopy too and suggests a 24-hour liquid diet for people at higher risk. Ask the team doing the procedure.

Why is a GLP-1 a problem for anesthesia?

GLP-1s slow how fast your stomach empties. The labels report rare cases of food going into the lungs under anesthesia in people who had fasted as told.

What does the UK say about GLP-1s and surgery?

The MHRA says to tell your healthcare team and anaesthetist, take your medicine as usual, and not stop without first talking to your doctor. The anaesthetist makes an individual risk assessment.

Sources

Checked against Wegovy, Ozempic, Zepbound and Mounjaro US prescribing information (2026), UK SmPCs (eMC, 2026), the 2024 multi-society perioperative guidance (Surg Endosc 2025), ASA guidance (2023, 2024) and MHRA Drug Safety Update (January 2025). How we check

  1. 1Wegovy (semaglutide) injection and tablets, US prescribing information, sections 5.10 and 17. Novo Nordisk, revised 06/2026
  2. 2Ozempic (semaglutide) injection, US prescribing information, sections 5.10 and 17. Novo Nordisk, revised 05/2026
  3. 3Zepbound (tirzepatide) US prescribing information and Medication Guide, section 5.9. Eli Lilly, revised 08/2026
  4. 4Mounjaro (tirzepatide) US prescribing information and Medication Guide, section 5.9. Eli Lilly, revised 08/2026
  5. 5Kindel TL, et al. Multi-society clinical practice guidance for the safe use of glucagon-like peptide-1 receptor agonists in the perioperative period. Surg Endosc 2025;39:180-183 (also Surg Obes Relat Dis 2024;20:1183-1186). AGA, ASMBS, ASA, ISPCOP and SAGES; doi:10.1007/s00464-024-11263-2
  6. 6American Society of Anesthesiologists: New multi-society GLP-1 clinical practice guidance released (press release). 29 Oct 2024
  7. 7American Society of Anesthesiologists consensus-based guidance on preoperative management of patients on GLP-1 receptor agonists. 29 Jun 2023
  8. 8MHRA Drug Safety Update: GLP-1 and dual GIP/GLP-1 receptor agonists: potential risk of pulmonary aspiration during general anaesthesia or deep sedation. 28 Jan 2025
  9. 9Mounjaro KwikPen, UK Summary of Product Characteristics, section 4.4 (same wording in the Wegovy and Ozempic SmPCs). eMC, updated 8 Sep 2026
  10. 10Potter TE, et al. Peri-operative glucagon-like peptide-1 receptor agonist use and outcomes: a national prospective multicentre cohort study. Anaesthesia 2026. doi:10.1111/anae.70380; published online 16 Sep 2026

This guide explains what labels and published studies say. It isn't medical advice and doesn't replace your prescriber or pharmacist.

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