If you are going to have UFE, UAE or OVE at Sydney fibroid clinic and you are taking GLP-1 medications, please follow the instruction provided in this pateint information leaflet:
GLP-1 MEDICATIONS — PRE-IR PROCEDURE FASTING PROTOCOL
For procedures performed under conscious IV sedation
Applies to patients taking GLP-1 / GLP-1–GIP medications, including:
Ozempic® / Wegovy® (semaglutide)
Mounjaro® (tirzepatide)
Trulicity® (dulaglutide)
Saxenda® / Victoza® (liraglutide)
and other GLP-1 receptor agonists.
Sedation: IV midazolam + fentanyl, titrated to conscious sedation with spontaneous ventilation.
- SHOULD THE PATIENT STOP THE GLP-1 MEDICATION?
NO — routine cessation is not required.
Current Australian/New Zealand recommendations advise patients to continue their GLP-1 medication before elective procedures.
Stopping Ozempic or another weekly GLP-1 medication for 7 days does not reliably eliminate delayed gastric emptying and should not be used as a substitute for appropriate dietary preparation and fasting.
- DAY BEFORE THE PROCEDURE
FROM WAKING — CLEAR FLUIDS ONLY
NO SOLID FOOD for the entire day.
Suitable clear fluids include:
- Water
- Clear apple juice
- Clear cordial
- Black tea or coffee without milk
- Clear electrolyte/sports drinks
- Clear broth without solids
Avoid:
- Milk or drinks containing milk
- Smoothies
- Protein drinks
- Thick or cloudy juices
- Alcohol
- Soup containing solids
- Any solid food
Patients should drink adequate clear fluids during the day to avoid dehydration.
- SIX HOURS BEFORE THE PROCEDURE
WATER ONLY
Stop all other clear fluids.
The patient may continue drinking water only.
- TWO HOURS BEFORE THE PROCEDURE
NOTHING BY MOUTH
No food.
No water.
No other drinks.
- ON ARRIVAL — NURSING CHECK
Confirm:
□ Patient is taking a GLP-1 medication.
□ Name of medication: ______________________
□ Last dose: _______________________________
□ Clear-fluid-only diet followed from waking yesterday.
□ No solid food consumed yesterday.
□ Water only during the final 6 hours.
□ Nothing orally during the final 2 hours.
Ask specifically about:
□ Nausea
□ Vomiting
□ Abdominal bloating/distension
□ Unusual feeling of fullness
□ Significant reflux/regurgitation
- PATIENT ATE SOLID FOOD THE DAY BEFORE
DO NOT AUTOMATICALLY CANCEL THE PROCEDURE.
Notify the proceduralist before administering IV sedation.
The patient should be considered at potentially increased risk of residual gastric contents despite conventional fasting.
The proceduralist should assess:
What was eaten?
What time was it eaten?
How long has the patient actually fasted?
Does the patient have nausea, vomiting, bloating, reflux or early satiety?
Is the patient newly taking the GLP-1 medication or undergoing dose escalation?
How necessary is sedation for the procedure?
- PROCEDURALIST DECISION
- Appropriate preparation completed
Proceed with planned conscious sedation.
Maintain:
- Spontaneous ventilation
- Verbal responsiveness where practicable
- Protective airway reflexes
- Careful titration of midazolam and fentanyl
- Preparation NOT completed but patient appears low risk
Do not assume that conventional fasting alone guarantees an empty stomach.
Options may include:
- delaying the procedure;
- further assessment of aspiration risk;
- point-of-care gastric ultrasound where expertise is available;
- modifying the sedation technique to minimise sedation and preserve airway reflexes.
Decision should be individualised and documented.
- Significant GI symptoms / high aspiration risk
Examples:
- Active nausea or vomiting
- Marked abdominal bloating
- Significant early satiety/fullness
- Suspected gastroparesis
- Recent GLP-1 commencement or dose escalation with GI symptoms
Consider postponing an elective procedure.
Clinical judgement remains necessary for individual patients.
Reference:
Sourced 9th August 2026
