Managing “Class Action” Adverse Effects Crucial for GLP-1 Medication Adherence

Glucagon-like peptide-1 (GLP-1) receptor agonists are one of the most effective weight loss tools currently available. However, some patients may find the common adverse events associated with these therapies too high of a burden to bear.

“The most common adverse effects of these incretin-based medications are gastrointestinal,” explained Robert Kushner, MD, MS. “It’s kind of a class action side effect for all of these medications.”

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Kushner is a professor of medicine and medicine education at the Northwestern University Feinberg School of Medicine in Chicago, Illinois. He spoke with Drug Topics ahead of the American Society for Preventive Cardiology Congress on CVD Prevention, held August 2 through August 4 in Salt Lake City, Utah.

Specific adverse events include nausea, diarrhea, and constipation, as well as the potential for vomiting and heartburn. The good news, though, is that these adverse effects can be mitigated—with careful management. The first step, according to Kushner, is following the package insert: health care providers should carefully manage dose escalation, which should help mitigate or reduce adverse effects.

Phase 3 trials have also provided insights into how these adverse effects can be managed. In addition to counseling patients to stick with a healthy diet, encourage them to reduce the amount of fat or fatty foods consumed, eat small meals, and plan ahead so that meals aren’t being skipped.

Since these medications are administered once a week through at home injections, patients have the flexibility to control when they take each dose. “Plan on taking the injection around a time where you have control of your diet for the next 1 to 2 days,” Kushner said. Patients whose lifestyle includes going out and eating in restaurants on the weekends shouldn’t dose themselves on Friday night or Saturday morning. Those with a regimented personal training or gym schedule should avoid medicating the day before a workout, which can lead to dehydration.

With just a little preparation, Kushner said, “we’re very successful in getting individuals on this medication and escalating them over the first few months.”

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