Allodynia (skin tenderness) associated with semaglutide: A case series

Jan 25, 2025American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists

Skin Tenderness Linked to Semaglutide: A Case Series

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Abstract

Four cases of allodynia were reported in patients prescribed a 2.4-mg dose of the GLP-1 receptor agonist semaglutide.

Allodynia, or skin pain to the touch, was observed in patients following dose escalation of semaglutide.
Symptoms were noted specifically at the 2.4-mg subcutaneous once-weekly dosage.
Two patients stopped therapy, resulting in resolution of their symptoms.
One patient who continued treatment experienced symptom resolution after 4 months.
A clear temporal and dose-response relationship was identified among the four cases.
No pharmacological mechanism for this adverse reaction was determined.

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PURPOSE: The glucagon-like peptide-1 receptor agonist (GLP-1RA) class of medications are widely prescribed for management of diabetes mellitus as well as obesity or weight management. Although there have been rare reports of skin hypersensitivity associated with GLP-1RA medications, no published reports have documented allodynia or skin pain to the touch.

SUMMARY: We report 4 cases of allodynia associated with dose escalation of the GLP-1RA medication semaglutide. Each patient was prescribed semaglutide for management of obesity and developed symptoms of allodynia with the 2.4-mg subcutaneous once-weekly dose. Therapy was stopped in 2 patients, both of whom had resolution of symptoms. Two patients opted to continue semaglutide despite the adverse effect, with one experiencing resolution after 4 months. No pharmacological mechanism was identified for this unique adverse drug reaction. There was a clear temporal and dose-response relationship in each of the 4 cases.

CONCLUSION: The 4 cases presented had scores of 5 or 6 (probable) on the Naranjo scale. It is not known whether this is a class effect of the GLP-1RA medications or if the adverse effect will consistently resolve or improve with continuation.

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Allodynia (skin tenderness) associated with semaglutide: A case series

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