Was just having an interesting conversation with a colleague the other day. Patient scheduled for elective surgery on Tuesday. Takes their ozempic on Tuesday. Took it the week prior (on Tuesday) then mistakenly took it again the morning of surgery (Tuesday). Sub-cue injection takes a full 24hrs to reach peak plasma concentration. They considered proceeding because based on drug kinetics, they basically followed guidelines, but ultimately opted to cancel/reschedule because it was purely elective and went against ASA guidelines by the letter.
This just further illustrated to me how stupid/inadequate the ASA guidelines are for these drugs.
Edit: If there’s enough residual drug left on day 7 to allow 24 hours for the drug to reach peak plasma concentration, theirs still must be enough drug floating around to give good clinical effect during that 24hrs immediately following the injection. Meaning that once drug has reached steady state, it’s must still be having good clinical effect, even 7 days since last injection, otherwise it would need to be dosed more frequently.