Safety briefing: GLP-1 receptor agonists – safety signals: October 2025

We have identified growing concerns from clinicians, regulators, and public health professionals on the use of GLP-1 receptor agonists.

This bulletin summarises the key safety issues emerging in Scotland and provides recommendations from HIS to support the safe use of these medicines.

Why this matters? 

GLP-1 (glucagon-like peptide-1) receptor agonists (e.g. tirepatide, semaglutide, liraglutide) are increasingly being used for weight management and diabetes. These drugs are effective for weight management but carry significant risks if used in pregnancy and the use of these medicines may also result in other serious complications such as acute pancreatitis. 

The specific concerns raised to us about GLP-1 receptor agonists are:

  • unintended exposure in early pregnancy  
  • Emergency Department presentations linked to serious side effects  
  • use of unlicensed preparations 

Emerging concerns in Scotland 

  • Increasing use through independent healthcare providers reported  
  • Challenges with access via online prescribing including accessing these medications without face-to face consultation 
  • Patients may misrepresent their health status to access the medicines 
  • Illicit supplies of counterfeit and unlicensed versions of medicines have been found to be available 
  • Intelligence that hospital admissions increased due to side effects and other serious complications 

HIS recommends 

Clinicians should: 

  • Be vigilant about private use of these medicines and the illicit supply of medicines as patients present 

To check the private provider is  a registered independent healthcare provider with HIS please use our website – Find an independent healthcare provider or service – Healthcare Improvement Scotland

  • Review prescribing practices for GLP-1 receptor agonists, especially in weight management and diabetes care, avoiding prescribing in pregnancy or where contraception is not in place 
  • Provide contraceptive counselling to individuals of childbearing potential before initiating treatment 
  • Ensure patients are aware of potential side effects, including pancreatitis and risks in pregnancy 
  • Report adverse events via the Yellow Card scheme, especially cases involving acute complications 
  • Document and escalate concerns about misuse or counterfeit supply 
  • Collaborate with local governance teams to ensure alignment with HIS recommendations and local safety policies 

The information contained should be considered by clinicians in the services that are provided in the care of patients who are being treated with GLP-1s. 

Other resources