How many days prior to elective major surgery do you recommend holding oral GLP 1 R agonist therapy?

Zero. Or, I suppose, if you're having surgery early in the morning, one.

This has gone back and forth, but the most recent guidance from the ASA (with other societies concurring) has been that most patients can continue their GLP medications as normal preoperatively, with higher-risk people being rec...

Anesthesiologists are suggesting at least 1 week off once-weekly GLP1RAs or tirzepatide prior to major surgery. Guidance for daily injections is less clear. One week is probably longer than necessary, 3-5 days is probably enough. The guidelines for stopping these medications prior to surgery general...

Oral semaglutide is dosed daily due to challenges with absorption, but once absorbed has about a 7-day half-life. Therefore, the risks due to slowing gastric emptying and potential aspiration during anesthesia could be similar to the once-weekly injectables. A holding for 10+ days recommendation mak...

10+ days.