Drug Shortages Due to Dual Indications

For those of you who are unaware, the glucagon-like peptide-1 (GLP-1) receptor agonist semaglutide, sold under the brand names Ozempic (semaglutide 0.5 mg, 1 mg, or 2 mg; Novo Nordisk) and Wegovy (semaglutide 2.4 mg, Novo Nordisk), is used to treat type 2 diabetes by keeping blood sugar levels in check. It is self-administered weekly as an injection and works by mimicking a hormone in the body that regulates insulin levels.

Ozempic has become an extremely in-demand medication—not because of the nation’s rising rates of diabetes, but rather because one of the side effects is that it can cause weight loss. In fact, the medication's active ingredient, semaglutide, is used for weight loss and is marketed and sold under the brand name Wegovy with a higher dosage. This medication has been in such demand that shortages have caused many prescribers to write Ozempic scripts off-label for weight loss. 

My Two Cents

As the basic laws of supply and demand dictate, where this is an unmet demand, others will try to satisfy it. As such, copycat versions of Ozempic and Wegovy have been extremely commonplace—so much so that individual states are cracking down on these unapproved versions of semaglutide. So far, at least four states (Louisiana, Mississippi, North Carolina, and Virginia) have already curbed the manufacture of copycat versions due to safety concerns, with more states expected to follow suit.

There are medications prescribed for ophthalmic use that have been approved for a totally different indication in another field of medicine. This type of situation could happen to our patients, and there’s really nothing we could do to prevent it, aside from prescribing alternative options, if any exist.

CAN YOU RELATE

Here in Louisiana, we’ve been at peak allergy season for a few weeks now, and the Williamson Dry Eye Center of Louisiana has been seeing patients from multiple states who have been seeking care for their allergies and ocular surface disease. 

Patients with allergic conjunctivitis are low-hanging fruit in our field and end up in our chairs every day. At Williamson Eye Center, we make a point to ask each patient if they are experiencing itchy, watery eyes. If so, we offer them treatment, which can vary from a once daily OTC antihistamine eye drop to a prescription antihistamine. For our toughest cases, we add a topical corticosteroid to the mix.

One thing we can’t forget is that a referral to an allergist can make a huge difference in the overall quality of life for our patients, all while getting to the root cause of their allergic conjunctivitis. I am fortunate that we have many local allergists who do wonderful work and who enjoy working closely with optometrists. A simple referral to them to treat the whole patient raises all boats. A few of our more rural colleagues have also been doing allergy testing in their own offices, as they don’t have immediate access to an allergy clinic. These colleagues benefit financially from performing such testing on their own.

HOT TOPIC

Do You Know Your True Eye Color?

I’m not exactly social media savvy—I have an Instagram account (@dryeyeod) that’s not regularly updated (I should probably work on that), and I don’t even have a TikTok account. Sometimes, however, a neat trend will emerge from one of these platforms—like the recent “eye color chart” on TikTok, which has accumulated thousands of views.

In this trend sweeping across the popular video app, users compare the color of their eyes to 15 different colors to find a match. The colors range from “red albino” to “very dark brown/black” and every color in between.

The color chart isn’t an official TikTok filter, but this article explains step by step how to search for the “TikTok Eye Color Chart,” save it to your camera reel, and get to finding your true eye color. Very cool!

QUOTE OF THE WEEK

“The greatest glory in living lies not in never falling, but in rising every time we fall.”

—Nelson Mandela