When to stop your GLP-1 before surgery

The two guidance sources this calendar uses

The American Society of Anesthesiologists published its first consensus statement on preoperative GLP-1 holds in June 2023 [1]. In October 2024, the ASA jointly published an updated multidisciplinary consensus with the American Gastroenterological Association, the American Society for Metabolic and Bariatric Surgery, the International Society for the Perioperative Care of Patients with Obesity, and the Society of American Gastrointestinal and Endoscopic Surgeons [2]. The 2024 update retains the 2023 default holds as the starting point but shifts the framework toward an individualized risk assessment that weighs aspiration risk against the harms of an unplanned GLP-1 interruption (loss of glycemic control in type 2 diabetes, weight regain, rebound nausea on restart).

The default holds

• Weekly-dose GLP-1s (Wegovy, Ozempic, Zepbound, Mounjaro, compounded semaglutide, compounded tirzepatide, other weekly GLP-1s like Trulicity / Bydureon) — hold for 1 week before the procedure.
• Daily-dose GLP-1s (oral Rybelsus, oral Foundayo, daily-injectable Saxenda) — hold the dose on the day of the procedure.

Both statements add: if the patient has significant GI symptoms on the day of surgery (nausea, vomiting, abdominal distention, dyspepsia), consider delaying the procedure regardless of the hold. If the procedure cannot be delayed, treat the patient as “full stomach” with rapid-sequence induction (with or without cricoid pressure) or substitute regional anesthesia where feasible.

What this tool is, and isn’t

The calendar is an educational planner that turns the ASA default holds into concrete calendar dates so you can have a specific conversation with your prescribing clinician and your anesthesia team. It is not a substitute for that conversation. The 2024 multisociety guidance explicitly frames the hold-or-continue decision as individualized — the calendar gives you the conservative default; your team decides whether to follow it, tighten it, or substitute an alternate plan based on your indication, procedure, and current GI symptoms.

The “I forgot to stop” branch

If you took a dose closer to your surgery date than the ASA default hold, the calendar surfaces three branches:

• On-schedule — your last dose is at or beyond the default hold. Still tell the anesthesia team the exact last-dose date at your pre-op visit.
• Too recent — your last dose is inside the default hold window but not extremely close to surgery. The anesthesia team may treat you as “full stomach” with rapid-sequence induction.
• Extremely recent (weekly GLP-1 with last dose <3 days before surgery) — call your surgical office and anesthesia team today. They will weigh delaying the procedure, full-stomach precautions, or substituting regional anesthesia.

How to use the printable summary

The print / save / copy panel below the result bundles your inputs, the computed dates, the recovery branch (if any), and the primary-source citation into a single text block. Print it, save it as PDF, or copy it into a portal message. Bring it to your pre-op visit and ask the anesthesia team to confirm or adjust the plan for your specific procedure.

Important disclaimer

This calendar uses the ASA default holds. It does not know your surgical procedure, your indication for the GLP-1, your renal function, your steady-state dose, or any other factor that your anesthesia team will weigh. Confirm any decision to hold, continue, or substitute with your surgeon, your prescribing clinician, and your anesthesia team.

Related tools and research

• Stopping GLP-1s before surgery — full ASA / multisociety walkthrough
• GLP-1 washout calculator — half-life-based clearance over time
• GLP-1 drug interaction checker
• GLP-1 side-effect timeline