What should I do with my GLP-1 before surgery, dental work, or another procedure?

Tell every doctor, surgeon, anesthesia provider, and dentist that you take a GLP-1 medication, as soon as your procedure is booked, and follow their instructions on whether to skip a dose and when to restart. They know your specific procedure and your risks, so their plan comes first.

Why your medical team cares

GLP-1 medications such as tirzepatide slow gastric emptying, which means food stays in your stomach longer. Under anesthesia or sedation, food left in the stomach can be breathed into the lungs, which is rare but serious. So before a procedure that needs fasting, anesthesia, or sedation, your team wants your stomach as empty as possible. Depending on your situation, they may ask you to skip your dose in the week before, or keep your dose and follow a liquid diet the day before. They may also keep an eye on constipation, since a GLP-1 combined with pain medication after a procedure can make constipation more likely.

Surgery

Should I stop before surgery? Not always. Many people can keep taking their GLP-1, and others are asked to skip one dose in the week before. Your surgeon or anesthesia team decides, so ask them at least a week ahead. Tell them:

• which medication you take (compounded tirzepatide or semaglutide) and your dose
• the date of your last injection
• whether you increased your dose recently
• whether you have nausea, vomiting, bloating, belly pain, or constipation

If you have any of those stomach symptoms on the day of your procedure, tell the team before you are sedated. They may decide to wait.

Heart surgery or other major surgery: Your surgical team may ask you to stop your injections before the procedure and to wait until you are eating and drinking normally before you restart. Ask them, and talk with your primary care provider about when it is appropriate to resume.

Restarting after surgery: Get clearance from your surgeon before you restart, and wait until you are eating and drinking normally. If you skipped only one dose, you can usually go back to your usual dose on your usual day. Once you are cleared, follow the restart guidance in "What if I miss my scheduled injection day?", which depends on how long you have been off the medication. If you are not sure where to restart, message your care team and your provider will tell you the right dose. Do not assume you can pick up at your previous dose after a longer break.

Dental work and other procedures

Endoscopy, colonoscopy, and sedated dental work (such as wisdom teeth): These count as procedures with sedation, so the same steps apply. Tell the team you take a compounded GLP-1 and follow their instructions, including any liquid diet or bowel prep. For dental work with only numbing shots and no sedation, still tell your dentist, and ask whether any change is needed.

Injecting on the same day as a dental procedure: Ask your dentist whether it is okay to inject that day, given your procedure and any antibiotics or pain relievers they prescribe. Follow their recommendation.

Back injections and similar procedures: There is no known interaction between a GLP-1 and a lower back injection. If your injection day lines up with the procedure, you can move your injection to another day that week if you prefer. Afterward, stick to one consistent injection day. Let your doctor know you take a GLP-1.

Pausing while you wait for results or tests

If you are waiting on a biopsy or another medical evaluation and would rather pause your medication in the meantime, that can be a reasonable choice. Message your care team and they will help you pause your treatment. Your provider will review when and how to restart.

When you are sick

If you have significant illness with vomiting, or severe side effects, check in with your care team before your next dose. See "How does dosing and dose increases work for GLP-1s?" and "What should I do if I'm experiencing side effects or adverse reactions to my medication?" for more.

Call 911 or go to the nearest emergency room for severe abdominal pain, trouble breathing, or any symptom that feels life-threatening.

Quick checklist

• Tell your surgeon, anesthesia team, or dentist you take a GLP-1.
• Ask whether to skip a dose before your procedure or keep it, and whether to follow a liquid diet the day before.
• Tell the team on the day if you have nausea, vomiting, bloating, or belly pain.
• Get clearance before you restart.
• Message your care team about your restart dose, especially if you have been off for more than a few weeks.