Ann Pharmacother

GLP-1 RAs may affect colonoscopy bowel prep

July 3, 2025

Study details: This retrospective, multicenter cohort study evaluated 1,006 outpatients undergoing colonoscopy, comparing 503 patients on GLP-1 RAs with 503 matched controls (matched for diabetes and cirrhosis). Primary endpoint was a composite measure of inadequate bowel preparation, including proceduralist assessments, narrative comments, and recommendations for extended prep or repeat procedures.

Results: GLP-1 RA use was significantly associated with inadequate bowel preparation (125 vs. 56 cases; odds ratio [OR], 2.6; 95% confidence interval [CI], 1.9–3.7). Repeat colonoscopies were also more frequent in the GLP-1 RA group (26 vs. 9; OR, 3.0; 95% CI, 1.4–6.5). All individual components of the composite outcome were more common in the GLP-1 RA cohort.

Clinical impact: GLP-1 RA therapy may compromise colonoscopy preparation quality, increasing the risk of suboptimal visualization and repeat procedures. Consider adjusting bowel prep protocols or timing of GLP-1 RA administration in patients scheduled for colonoscopy.

Source:

Cole JL, et al. (2025, June 30). Ann Pharmacother. Impact of Glucagon-like Peptide-1 Receptor Agonists on Bowel Preparation for Colonoscopy: A Large, Matched Regional Cohort. https://pubmed.ncbi.nlm.nih.gov/40583805/