Risks of Ozempic and Similar Drugs: A Focus on NAION

Risks of Ozempic, A Focus on NAION. Ozempic, a popular medication containing semaglutide, is widely used for managing type 2 diabetes and aiding weight loss.

As a glucagon-like peptide-1 receptor agonist (GLP-1 RA), it has transformed treatment for diabetes and obesity, offering benefits like improved glycemic control and reduced cardiovascular risks.

However, recent studies have raised concerns about potential side effects, including a rare but serious eye condition called non-arteritic anterior ischemic optic neuropathy (NAION).

This blog explores the risks associated with Ozempic and similar drugs, with a particular emphasis on NAION, to help patients make informed decisions about their treatment.

What is Ozempic and How Does It Work?

Ozempic, along with its counterpart Wegovy, contains semaglutide, a GLP-1 Receptor Agonist that mimics a hormone regulating appetite and insulin levels.

Approved by the FDA in 2017 for type 2 diabetes and later for weight management, it helps lower blood sugar, reduce hunger, and promote significant weight loss.

Its popularity has surged, with weekly new-to-brand prescriptions of GLP-1 RA drugs increasing by about 60% from 2021 to 2023. While these benefits are substantial, emerging research highlights potential risks that warrant attention.

Non-Arteritic Anterior Ischemic Optic Neuropathy (NAION): A Serious Concern

NAION is a rare but severe eye condition often described as a “stroke of the optic nerve.” It occurs due to reduced blood flow to the optic nerve, leading to sudden, painless vision loss, typically in one eye.

NAION is the second most common optic nerve disease in the United States, affecting up to 10 out of 100,000 people, and there is no known effective treatment, making it a leading cause of sudden blindness.

Risk factors include type 2 diabetes, hypertension, obesity, sleep apnea, certain medications, and anatomical features like a “disk at risk” (a crowded optic disc).

Recent studies have suggested a potential link between semaglutide use and an increased risk of NAION. This association has sparked concern among researchers, healthcare providers, and patients, prompting further investigation into the safety profile of Ozempic and similar drugs.

Medications implicated in an increased risk of non-arteritic anterior ischemic optic neuropathy (NAION) include:

1. Semaglutide (Ozempic, Wegovy): Studies, including a 2024 JAMA Ophthalmology study, found a 4-7 times higher risk of NAION in patients using semaglutide for type 2 diabetes or weight loss compared to those on other treatments. Danish studies (2024) reported a 2.19-2.81 times higher risk, though the absolute risk remains low (1.41 additional cases per 10,000 person-years).
2. Other GLP-1 Receptor Agonists: While semaglutide is the most studied, other GLP-1 RAs (e.g., liraglutide, dulaglutide) may carry similar risks, though evidence is less robust and requires further investigation.
3. Phosphodiesterase-5 Inhibitors (PDE-5i): Drugs like sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra), used for erectile dysfunction, have been associated with NAION. Case reports and studies, such as a 2015 JAMA Ophthalmology analysis, suggest a temporal link, with a 2-fold increased risk in some observational data, particularly in patients with vascular risk factors.
4. Amiodarone: This antiarrhythmic drug for heart rhythm disorders has been linked to NAION in case reports. A 2006 study in American Journal of Ophthalmology noted optic neuropathy in some patients, though distinguishing between NAION and amiodarone-induced optic neuropathy remains challenging.
5. Interferon-Alpha: Used for hepatitis C and certain cancers, interferon-alpha has been associated with NAION in rare cases, as reported in studies like a 1996 Ophthalmology article, potentially due to its effects on vascular flow.

Key Notes:

• Mechanism: These medications may contribute to NAION by affecting blood flow (e.g., hypotension from GLP-1 RAs or vasodilation from PDE-5 inhibitors) or through inflammatory or vascular changes, particularly in patients with predisposing factors like diabetes, hypertension, or a “disk at risk.”

Evidence Linking Ozempic to NAION

Harvard Study (2024)

A study published in JAMA Ophthalmology in July 2024, conducted by researchers at Massachusetts Eye and Ear, found that patients prescribed semaglutide for diabetes or weight loss had a significantly higher risk of developing NAION.

Among 710 patients with type 2 diabetes, those taking semaglutide were over four times more likely to be diagnosed with NAION compared to those on non-GLP-1 RA medications.

For 979 overweight or obese patients, the risk was over seven times higher, with a cumulative incidence of 6.7% for semaglutide users versus 0.8% for others over 36 months. The study, which analyzed over 16,800 patient records, was prompted by an unusual cluster of NAION cases in patients taking semaglutide.

University of Southern Denmark Studies (2024)

Two studies from the University of Southern Denmark, published in December 2024, further corroborated these findings.

In a nationwide cohort of 424,152 Danish patients with type 2 diabetes, those using semaglutide (106,454 patients) had a 2.19 times higher risk of NAION compared to those on other diabetes treatments.

The incidence rate was 0.228 per 1,000 person-years for semaglutide users versus 0.093 for non-users.

A second study, incorporating Danish and Norwegian data, reported a pooled hazard ratio of 2.81 for NAION among semaglutide users. While the absolute risk remains low (1.41 additional NAION events per 10,000 person-years), the findings highlight a consistent association.

Case Reports and Additional Evidence

A case report published in Neuro-Ophthalmology described a 73-year-old man with type 2 diabetes, obesity, and hypertension who developed bilateral NAION after significant weight loss and postural hypotension while on semaglutide.

This case suggests that rapid physiological changes, such as weight loss or blood pressure fluctuations, may contribute to NAION risk in susceptible individuals.

Additionally, the FDA’s adverse event reporting system has noted NAION cases linked to semaglutide, though the data is not yet sufficient to establish causality.

Other Risks of Ozempic and Similar Drugs

Beyond NAION, Ozempic and other GLP-1 RAs have been associated with additional side effects, including:

• Gastrointestinal Issues: Common side effects include nausea, vomiting, diarrhea, and, in rare cases, gastroparesis (stomach paralysis) or bowel obstruction. These have led to over 2,000 lawsuits against Ozempic’s manufacturer, Novo Nordisk.

• Diabetic Retinopathy: Rapid improvements in blood sugar levels can worsen diabetic retinopathy, a condition damaging retinal blood vessels, potentially leading to blurred vision or vision loss.

• Cardiovascular and Other Risks: While semaglutide reduces cardiovascular risks in some patients, it may increase the risk of blood clots, such as deep vein thrombosis or pulmonary embolism, particularly when combined with other diabetes medications.

Conclusion Risks of Ozempic A Focus on NAION

Ozempic and similar GLP-1 RA drugs offer significant benefits for managing type 2 diabetes and obesity, but emerging evidence suggests a potential link to NAION, a rare and serious eye condition.

Studies from Harvard and the University of Southern Denmark indicate a 2-7 times higher risk of NAION among semaglutide users, though the absolute risk remains low.

Eligibility for an Ozempic and NAION Lawsuit

Financial compensation may be available via an Ozempic and NAION lawsuit settlement for people who received name-brand Ozempic injections and suffered from NAION.

Dr. Shezad Malik Law Firm is investigating Ozempic and NAION lawsuits against Novo Nordisk for people throughout the United States who have developed NAION injuries that could have been prevented.

To determine if you or a loved one qualifies for an Ozempic and NAION Lawsuit, submit information for review, and we will evaluate the circumstances of your potential claim. There are no fees or expenses paid unless a settlement or lawsuit payout is received.

Contact Dr Shezad Malik Law Firm Now for NAION Injuries

If you or a loved one uses Ozempic or Wegovy for weight loss or diabetes treatment and has developed NAION, contact the attorneys at Dr. Shezad Malik Law Firm to learn more about your legal rights. You can speak with one of our representatives by calling 214-390-3189 or by filling out the case evaluation form on this page.

Our law firm’s principal office is in Dallas, Texas. Dr. Shezad Malik Law Firm represents clients in dangerous drug and dangerous medical device lawsuits nationwide.

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