Weight loss medications - Revision history

Ellouise.Bishop@anthonynolan.org at 16:17, 29 October 2026

2026-10-29T16:17:17Z

← Older revision		Revision as of 16:17, 29 October 2026
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	Orlistat is a tablet medication that works by decreasing the amount of fat absorbed from food, and can be prescribed via the NHS.		Orlistat is a tablet medication that works by decreasing the amount of fat absorbed from food, and can be prescribed via the NHS.

	Rybelsus is an oral GLP-1 agonist which is available off-license. It is ~~not~~ available via the NHS.		Rybelsus is an oral GLP-1 agonist which is available off-license. Wegovy Pill (Oral Semaglutide 25 mg) is also now licensed by the MHRA for weight management as a once-daily tablet. It is available via private prescription providers, though not yet funded or widely offered through the NHS.

	Naltrexone–bupropion (Mysimba) works by decreasing appetite and cravings. It is not available via the NHS.		Naltrexone–bupropion (Mysimba) works by decreasing appetite and cravings. It is not available via the NHS.
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	<u>Medical history</u>		<u>Medical history</u>

	*Ask the patient whether they have a diagnosis of type 2 diabetes. If the GLP-1 medication is also being used to control diabetes, please see the [[Diabetes Mellitus]] page.		*Ask the patient whether they have a diagnosis of type 2 diabetes. If the GLP-1 medication is also being used to control diabetes, please see the [[Diabetes Mellitus]] page, it is not acceptable to ask donors to hold medications controlling their diabetes.
	* ~~Ask the~~ donor ~~about their~~ current BMI and refer to the corresponding guidelines in the [[Weight]] section. A donor’s BMI is likely to fall when taking GLP-1 agonists, so it may be appropriate to make the donor TU for a period if their BMI is currently above our discretionary limits.		*Check donor's current BMI and refer to the corresponding guidelines in the [[Weight]] section. A donor’s BMI is likely to fall when taking GLP-1 agonists, so it may be appropriate to make the donor TU for a period if their BMI is currently above our discretionary limits and check it has not fallen during the process for accurate weight based dosing prescribing.
	* Determine whether the donor is experiencing any significant side effects related to their current medication regimen. Common side effects include nausea and stomach upset. If the donor is experiencing unpleasant side effects, defer the donation until they have ~~settled~~, or the donor ceases the medication.		* Determine whether the donor is experiencing any significant side effects related to their current medication regimen. Common side effects include nausea and stomach upset. If the donor is experiencing unpleasant side effects, defer the donation until they have resolved, or the donor ceases the medication.


	<u>Source of medication</u>		<u>Source of medication</u>

	* Weight loss medications ~~may~~ be accessed through the NHS, but they are often obtained privately.		* Weight loss medications can be accessed through the NHS, but they are often obtained privately.
	* If the donor has acquired the medication from an online pharmacy, confirm that the pharmacy is properly registered. You can check registration status through NHS resources:

			* If the donor has acquired the medication from an online pharmacy, confirm that the service is properly registered (e.g. General Pharmaceutical Council (GPhC)).

			You can also check registration status through NHS resources:
	https://www.nhs.uk/service-search/other-health-services/pharmacies/internetpharmacies		https://www.nhs.uk/service-search/other-health-services/pharmacies/internetpharmacies

	* ~~Check the medical~~ or ~~nursing registration number~~ of the ~~prescribing clinician for donors who have obtained~~ the ~~medication through a clinic~~.		* If an injectable weight loss drug has been obtained from an unverified or non-legitimate source, apply a deferral period of three months between the last injection date and the donation should apply but this may be reduced at the discretion of the MO and TC.

	* If an injectable weight loss drug has been obtained from an unverified or non-legitimate source, apply a deferral period of three months between the last injection date and the donation. This deferral period may be reduced at the discretion of the MO and TC.		* For non-injectable weight loss drugs (i.e. in tablet form) obtained from an unverified source, discuss with MO.

	* For non-injectable weight loss drugs (i.e. in tablet form) obtained from an unverified source, discuss ~~the case~~ with an MO.

	* Naltrexone–bupropion (Mysimba) – discuss with MO even if the medication has been obtained from a reliable source.		* Naltrexone–bupropion (Mysimba) – discuss with MO even if the medication has been obtained from a reliable source.
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	<u> Bone marrow harvests </u>		<u> Bone marrow harvests </u>

	Donors taking weight loss injections are suitable for a bone marrow harvest. However, a washout period ~~of 2 weeks~~ should be undertaken between the last dose of the weight loss ~~injection~~ and for the donation. ~~This can~~ be one or two doses.		Donors taking weight loss injections are suitable for a bone marrow harvest. However, a washout period should be undertaken between the last dose of the weight loss medicine and for the donation. For injections this should be 2 weeks and may be one or two doses. For oral medication this can be more variable and would need to be flagged to the anaesthetist in advance.

	For an emergency bone marrow harvest where holding a medication dose is not possible, the decision to proceed is undertaken on a risk-benefit basis after discussion with the donor. This decision would be undertaken by the anaesthetist.		For an emergency bone marrow harvest where holding a medication dose is not possible, the decision to proceed is undertaken on a risk-benefit basis after discussion with the donor. This decision would be undertaken by the anaesthetist.

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	Naltrexone–bupropion (Mysimba) interacts with some painkillers and anaesthetic drugs. Therefore, any donor taking this medication should be discussed with an MO.		Naltrexone–bupropion (Mysimba) interacts with some painkillers and anaesthetic drugs. Therefore, any donor taking this medication should be discussed with an MO.

	Weight loss medications increase anaesthetic risk due to the risk of aspiration secondary to reduced gut motility, ~~hence~~ the ~~recommendation to omit a dose for~~ planned ~~BMHs.~~		Weight loss medications increase anaesthetic risk due to the risk of aspiration secondary to reduced gut motility. Bone marrow donors taking these drugs may require longer pre-operative periods of fasting than would otherwise be the case, so anaesthetics staff must be informed well in advance of the planned date of bone marrow harvest

	==Version==		==Version==
	Version 1, Edition 1		Version 1, Edition 2

	====Date of Last Update====		====Date of Last Update====
	2nd July 2025		2nd July 2025
			29th October 2026

Frances.Sarkari@anthonynolan.org: /* Guidance at VT */

2026-04-02T09:46:48Z

Guidance at VT

← Older revision		Revision as of 09:46, 2 April 2026
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	Donors taking weight loss injections are suitable for a bone marrow harvest. However, a washout period of 2 weeks should be undertaken between the last dose of the weight loss injection and for the donation. This can be one or two doses.		Donors taking weight loss injections are suitable for a bone marrow harvest. However, a washout period of 2 weeks should be undertaken between the last dose of the weight loss injection and for the donation. This can be one or two doses.
	For an emergency bone marrow harvest where holding a medication dose is not possible, the decision to proceed is undertaken on a risk-benefit basis after discussion with the donor. This decision would be undertaken by the anaesthetist.		For an emergency bone marrow harvest where holding a medication dose is not possible, the decision to proceed is undertaken on a risk-benefit basis after discussion with the donor. This decision would be undertaken by the anaesthetist.

			Donors taking GLP-1 medication for diabetic control also should not stop this medication, and should only be for PBSC donation only.

	==Justification==		==Justification==

Frances.Sarkari@anthonynolan.org: /* Guidance at VT */

2026-04-02T09:38:25Z

Guidance at VT

← Older revision		Revision as of 09:38, 2 April 2026
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	<u>Medical history</u>		<u>Medical history</u>

	*Ask the patient whether they have a diagnosis of type 2 diabetes. If the GLP-1 medication is also being used to control diabetes, please see the [[~~diabetes mellitus~~]] page.		*Ask the patient whether they have a diagnosis of type 2 diabetes. If the GLP-1 medication is also being used to control diabetes, please see the [[Diabetes Mellitus]] page.
	* Ask the donor about their current BMI and refer to the corresponding guidelines in the [[Weight]] section. A donor’s BMI is likely to fall when taking GLP-1 agonists, so it may be appropriate to make the donor TU for a period if their BMI is currently above our discretionary limits.		* Ask the donor about their current BMI and refer to the corresponding guidelines in the [[Weight]] section. A donor’s BMI is likely to fall when taking GLP-1 agonists, so it may be appropriate to make the donor TU for a period if their BMI is currently above our discretionary limits.
	* Determine whether the donor is experiencing any significant side effects related to their current medication regimen. Common side effects include nausea and stomach upset. If the donor is experiencing unpleasant side effects, defer the donation until they have settled, or the donor ceases the medication.		* Determine whether the donor is experiencing any significant side effects related to their current medication regimen. Common side effects include nausea and stomach upset. If the donor is experiencing unpleasant side effects, defer the donation until they have settled, or the donor ceases the medication.

Frances.Sarkari@anthonynolan.org: /* Guidance at VT */

2026-04-02T09:37:23Z

Guidance at VT

← Older revision		Revision as of 09:37, 2 April 2026
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	<u>Medical history</u>		<u>Medical history</u>

	*Ask the patient whether they have a diagnosis of type 2 diabetes. If the GLP-1 medication is also being used to control diabetes, please see the diabetes page.		*Ask the patient whether they have a diagnosis of type 2 diabetes. If the GLP-1 medication is also being used to control diabetes, please see the [[diabetes mellitus]] page.
	* Ask the donor about their current BMI and refer to the corresponding guidelines in the [[Weight]] section. A donor’s BMI is likely to fall when taking GLP-1 agonists, so it may be appropriate to make the donor TU for a period if their BMI is currently above our discretionary limits.		* Ask the donor about their current BMI and refer to the corresponding guidelines in the [[Weight]] section. A donor’s BMI is likely to fall when taking GLP-1 agonists, so it may be appropriate to make the donor TU for a period if their BMI is currently above our discretionary limits.
	* Determine whether the donor is experiencing any significant side effects related to their current medication regimen. Common side effects include nausea and stomach upset. If the donor is experiencing unpleasant side effects, defer the donation until they have settled, or the donor ceases the medication.		* Determine whether the donor is experiencing any significant side effects related to their current medication regimen. Common side effects include nausea and stomach upset. If the donor is experiencing unpleasant side effects, defer the donation until they have settled, or the donor ceases the medication.

Frances.Sarkari@anthonynolan.org: /* Guidance at VT */

2026-04-02T09:36:00Z

Guidance at VT

← Older revision		Revision as of 09:36, 2 April 2026
Line 36:		Line 36:
	<u>Medical history</u>		<u>Medical history</u>

	*Ask the patient whether they have a diagnosis of type 2 diabetes.		*Ask the patient whether they have a diagnosis of type 2 diabetes. If the GLP-1 medication is also being used to control diabetes, please see the diabetes page.
	* Ask the donor about their current BMI and refer to the corresponding guidelines in the [[Weight]] section. A donor’s BMI is likely to fall when taking GLP-1 agonists, so it may be appropriate to make the donor TU for a period if their BMI is currently above our discretionary limits.		* Ask the donor about their current BMI and refer to the corresponding guidelines in the [[Weight]] section. A donor’s BMI is likely to fall when taking GLP-1 agonists, so it may be appropriate to make the donor TU for a period if their BMI is currently above our discretionary limits.
	* Determine whether the donor is experiencing any significant side effects related to their current medication regimen. Common side effects include nausea and stomach upset. If the donor is experiencing unpleasant side effects, defer the donation until they have settled, or the donor ceases the medication.		* Determine whether the donor is experiencing any significant side effects related to their current medication regimen. Common side effects include nausea and stomach upset. If the donor is experiencing unpleasant side effects, defer the donation until they have settled, or the donor ceases the medication.

Frances.Sarkari@anthonynolan.org: /* Guidance at VT */

2026-03-31T14:06:56Z

Guidance at VT

← Older revision		Revision as of 14:06, 31 March 2026
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	<u>Medical history</u>		<u>Medical history</u>

	*Ask the patient whether they have a diagnosis of type 2 ~~diabetes. If they do and they take a GLP-1 agonist, the donor cannot donate per our guidelines for~~ diabetes.		*Ask the patient whether they have a diagnosis of type 2 diabetes.
	* Ask the donor about their current BMI and refer to the corresponding guidelines in the [[Weight]] section. A donor’s BMI is likely to fall when taking GLP-1 agonists, so it may be appropriate to make the donor TU for a period if their BMI is currently above our discretionary limits.		* Ask the donor about their current BMI and refer to the corresponding guidelines in the [[Weight]] section. A donor’s BMI is likely to fall when taking GLP-1 agonists, so it may be appropriate to make the donor TU for a period if their BMI is currently above our discretionary limits.
	* Determine whether the donor is experiencing any significant side effects related to their current medication regimen. Common side effects include nausea and stomach upset. If the donor is experiencing unpleasant side effects, defer the donation until they have settled, or the donor ceases the medication.		* Determine whether the donor is experiencing any significant side effects related to their current medication regimen. Common side effects include nausea and stomach upset. If the donor is experiencing unpleasant side effects, defer the donation until they have settled, or the donor ceases the medication.

Maram.Ghiti@anthonynolan.org: /* Guidance at VT */

2025-08-06T10:11:39Z

Guidance at VT

← Older revision		Revision as of 10:11, 6 August 2025
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	<u> Bone marrow harvests </u>		<u> Bone marrow harvests </u>

	Donors taking weight loss injections are suitable for a bone marrow harvest. However, ~~they~~ should ~~hold one~~ dose ~~prior to~~ the ~~operation~~.		Donors taking weight loss injections are suitable for a bone marrow harvest. However, a washout period of 2 weeks should be undertaken between the last dose of the weight loss injection and for the donation. This can be one or two doses.
	For an emergency bone marrow harvest where holding a medication dose is not possible, the decision to proceed is undertaken on a risk-benefit basis after discussion with the donor. This decision would be undertaken by the anaesthetist.		For an emergency bone marrow harvest where holding a medication dose is not possible, the decision to proceed is undertaken on a risk-benefit basis after discussion with the donor. This decision would be undertaken by the anaesthetist.

Maram.Ghiti@anthonynolan.org at 16:20, 24 July 2025

2025-07-24T16:20:31Z

← Older revision		Revision as of 16:20, 24 July 2025
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	====Date of Last Update====		====Date of Last Update====
	~~11th April~~ 2025		2nd July 2025

Maram.Ghiti@anthonynolan.org: /* Guidance */

2025-07-02T14:46:55Z

Guidance

← Older revision		Revision as of 14:46, 2 July 2025
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	==Guidance==		==Guidance==

	~~AT RECRUITMENT~~		=== Guidance at recruitment ===

	Acceptable		Acceptable

			=== Guidance at VT ===
	AT VT

	The use of weight loss medications is generally acceptable, but the following steps should be taken:		The use of weight loss medications is generally acceptable, but the following steps should be taken:

Maram.Ghiti@anthonynolan.org: /* Guidance */

2025-07-02T14:45:33Z

Guidance

← Older revision		Revision as of 14:45, 2 July 2025
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	Acceptable		Acceptable

	~~Ask the patient whether they have a diagnosis of type 2 diabetes. If they do and they take a GLP1 agonist, the donor cannot donate per our guidelines.~~