Aug. 22, 2023 – In horse racing, a “false favourite” is a horse whose odds don’t mirror its skills, and who’s unlikely to ship. The identical is true of faux or counterfeit variations of the drug semaglutide, bought as Wegovy for weight reduction and as Ozempic for sort 2 diabetes, that are flooding North American and world marketplaces. 

The temptation is nice, main hundreds to threat their well being to search out these merchandise by any means attainable. Even some medical doctors are stepping into the shell recreation, although the percentages (and security) are stacked.

Over the previous 2 years, the surge in curiosity and recognition catapulted Wegovy from weight problems clinics to the world of Hollywood stars and TikTok influencers. The consequence has been a boon for Danish drugmaker Novo Nordisk, together with manufacturing complications linked to restricted provides, shortages, and a surge in counterfeits. 

Whereas Novo Nordisk takes authorized motion in opposition to medical spas, weight reduction and wellness clinics, and even compounding pharmacies, case stories describe administration errors and unintentional overdoses, calls to poison management middle hotlines, and visits to hospital emergency rooms. 

For thousands and thousands of sufferers who depend on entry to those medicines, forewarned is actually forearmed; how have you learnt a faux from the true deal? 

“We’ve gotten calls about a number of of those instances,” mentioned Jimmy Leonard, PharmD,director of medical providers on the Maryland Poison Middle on the College of Maryland College of Pharmacy in Baltimore. “We’ve had individuals give themselves tenfold overdoses proper off the bat,” he mentioned. 

“Boy, had been they sick.”

Amber Johnson, PharmD, director of the Utah Poison Management Middle and an assistant professor of pharmacy on the College of Utah in Salt Lake Metropolis, mentioned “we’ve really had as many stories up thus far as we had in 2022,” additionally noting that almost all had been calls about compounding errors.

Compounded medicines will not be FDA-approved however are allowed to be made throughout an official drug scarcity. Ozempic and Wegovy are at present on the FDA’s scarcity listing, however the federal company warned in Might that it has acquired stories of individuals having “opposed occasions” after utilizing compounded variations of the medication.

Johnson, co-author of a semaglutide case collection revealed in late June, mentioned that in 2022, there have been greater than thrice as many instances of unintentional administration errors and opposed occasions associated to semaglutide than in 2021. 

All instructed, poison management facilities throughout the nation are seeing increasingly of those instances, which Johnson mentioned is a trigger for concern. 

“With these errors, persons are having extended uncomfortable side effects which have landed just a few of them within the emergency division.” she mentioned.

Compounding vs. Counterfeit

In its warning in Might, the FDA mentioned some merchandise being bought as semaglutide won’t comprise the identical lively ingredient because the FDA-approved model however relatively a salt kind, which haven’t been proven to be both secure or efficient. 

Novo Nordisk (which declined to talk with WebMD) adopted with its personal assertion just a few weeks later, alerting the general public {that a} counterfeit formulation of Ozempic was circulating within the U.S. This model contained a long-acting type of insulin and led to an opposed response. In each conditions, the offender was compounding pharmacies.

Compounding refers to creating a customized type of a medicine to satisfy a selected want (for instance, eradicating one thing {that a} affected person is likely to be allergic to, reminiscent of lactose or a dye). 

As a result of compounded medication don’t require FDA evaluate, they might carry sure dangers, particularly when the compound pharmacist doesn’t have entry to the precise FDA-approved part, which on this case is a patented chain of amino acids or proteins that cross the blood-brain barrier. This distinctive attribute is a vital motive why Wegovy works so properly for persistent weight administration – it targets part of the mind that regulates urge for food. It is usually an essential motive why it’s in such excessive demand. 

Susan M., a 45-year outdated journalist from Texas who gained 100 kilos after the beginning of her second youngster, defined that taking Wegovy helped her personally settle for and perceive the illness means of weight problems in ways in which she had not earlier than. 

“It wasn’t till I took that drug that I considered it the identical means that I would consider taking a drug for blood sugar or an antihypertensive for blood stress or one thing like that,” she mentioned. “The factor that blew my thoughts was the absence of ‘meals noise,’ like meals is all the time on the sting of your ideas,” she mentioned. 

Weight problems drugs consultants agree on the drug’s distinctive qualities and effectiveness. 

“With older medicines, solely about 10% of individuals had been in a position to obtain a 20% weight reduction. With semaglutide, 40% of individuals are actually in a position to get into that 20% weight reduction class, which is why there’s a lot demand for it,” mentioned Angela Fitch, MD, chief medical officer of well being care firm Knownwell, and president of the Weight problems Drugs Affiliation.

However Fitch additionally identified that “any compounded product right this moment is counterfeit. The bottom supply isn’t coming from firms which are legally allowed to make it, and there’s no management over it. It’s like [the television show] Breaking Unhealthy,” she mentioned. 

Thoughts you, compounding merchandise is just not unlawful; the method is allowed – particularly throughout drug shortages – as long as sure high quality management and different necessities within the Federal Meals, Drug, and Beauty Act are met. At present, Novo Nordisk is the one firm within the U.S. with the patents for Ozempic and Wegovy, and no FDA-approved generic variations of semaglutide exist. That implies that Ozempic or Wegovy obtained from a compounding pharmacy, a medical spa, or on-line is just not the real article, has not had an intensive evaluate or met high quality requirements, and is likely to be downright harmful.

“There are lots of people determined for medicines. And there are lots of people that say, ‘Hey, I understand how we will make a fast buck.’ That mixture results in some unscrupulous actions,” mentioned Leonard.

Methods to Spot Pretend Wegovy or Ozempic

On Aug. 10, Novo Nordisk instructed Reuters that though it was spending billions to spice up output, shortages would final into 2024. So the corporate has an internet site to assist customers inform the distinction between FDA-approved and counterfeit merchandise. (Each Leonard and Johnson mentioned that compounding pharmacies are principally dishing out their variations in a liquid vial and an insulin syringe relatively than a pen, which make calculating correct dosage very tough.)

For reference, real Ozempic pens:

  • Don’t lengthen or enhance in size when setting the dose
  • Are at present obtainable in three doses: 0.25/0.5-milligram pen, 1-milligram pen, or 2-milligram pen
  • Are available a field that features 4 needles that instantly connect to the pen, besides the 0.25/0.5-milligram dose, which comes with six needles
  • Solely present meant does when dialed up from 0

The corporate has additionally instructed customers that though it’s not but found Wegovy counterfeits within the U.S., customers ought to look out for the next:

  • Real Wegovy pens come as fixed-dose auto-injectors, and do not need a push button to manage the treatment.
  • There is no such thing as a choice to set a dose or enhance the size of the pen. Fairly, pens can be found in 0.25 milligram, 0.5 milligram, 1 milligram, 1.7 milligrams, and a pair of.4 milligrams.

The counterfeit downside is predicted to worsen, which all the consultants we spoke to mentioned was an amazing trigger for concern.

Fitch didn’t mince phrases.

“This drug semaglutide is a drug that crosses the blood-brain barrier; it goes into your mind. In case you are getting one thing from someplace with out oversight, with out somebody monitoring manufacturing, that’s scary,” she mentioned. 

Scary or not, data is just not sufficient to detract sufferers like Susan M., who mentioned that regardless of the dangers, she was prepared to take an opportunity when her present provide of one other treatment had run out and if her insurance coverage firm turned down a request to cowl Wegovy. 

“Earlier than, I used to be useless set in opposition to compounding. However now? Properly, if that’s my solely possibility, then I’ll do it as a result of it’s higher than nothing,” she mentioned.

If You See One thing, Say One thing

The corporate is asking customers to buy their medicines by way of licensed distributors, and evaluate the images to make sure they’re receiving the true product and never a faux. To report suspected counterfeit semaglutide merchandise, they need to name Novo Nordisk buyer care at 800-727-6500 Monday-Friday, 8:30 a.m. to six p.m. ET.

When you’ve got any uncomfortable side effects associated to make use of of a probably counterfeit product, cease instantly and call nationwide Poison Management at 800-222-1222 and/or go to the nationwide web site.

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