Patients taking GLP-1 receptor agonists within four weeks of anaesthesia for non-endoscopic procedures should be considered non-fasted, according to new guidance.

Doctors are also advised to consider using IV erythromycin, in the absence of contraindications, at least one hour prior to emergency or urgent endoscopic procedures to accelerate gastric emptying in GLP-1 receptor agonist (RA) users.

The clinical practice recommendations on periprocedural use of the drug class — developed by peak medical bodies including the Australian Diabetes Society and Australian and New Zealand College of Anaesthetists — were published this month to improve patient safety.

It follows recent reports of retained gastric contents and pulmonary aspiration during endoscopic and non-endoscopic procedures requiring anaesthesia in patients using GLP-1 RAs.