By Mia Stephens  

As popularity continues to skyrocket, federal health officials and providers are becoming increasingly concerned about patients taking the wrong amount of their weight loss medications. 

Between 2019 and 2025, there was a nearly 1,500% increase in calls to poison centers in the United States about overdoses or side effects from injectable GLP-1 drugs, according to the American Poison Centers. 

“The significant increase in calls involving GLP-1 medications fall parallel with their growing use for diabetes and weight management,” said John Downs, M.D., MPH, director of the Virginia Poison Center at VCU. “At our center, exposure calls have steadily increased since 2022 and, as of mid-June 2026, we have already managed around 130 exposures so far this year.” 

While most poison center calls often reflect dosing slip-ups, questions about side effects and proper medication use, Susan Wolver, M.D., clinic director of the VCU Health Medical Weight Loss Program, has seen a rise in another safety concern on social media. Patients who sometimes want to see results quickly and adjust their own dosage based on advice from social media influencers rather than following guidance from their provider. 

“We’ve seen a rise in interest with patients using advice from social media trends where individuals are extracting multiple doses from a single-use vial or transferring the medications between containers,” Wolver said. “Participating in trends like this can increase your risk of contamination and serious infection, which we strongly discourage.” 

VCU Health News spoke with Downs and Wolver about trends related to excessive dosing with GLP-1 medications and how you can avoid dosing mistakes with use. 

Why do people call the poison center about GLP-1 weight loss drugs?  

Because of the widespread availability of GLP-1s medications for weight loss, poison centers are experiencing a rise in calls from patients adjusting doses on their own. Many cases typically involve someone who is confused about a recommended dose, dosing schedules or instructions for how to take the medication with a syringe or injection device properly.  

Other questions stem from medications classified as compounded or custom-mixed that require you to measure each dose with a syringe. 

“Oftentimes medications that require measuring out doses manually lead to confusion with measurements with milligram, milliliters, units or syringe marking that can lead to an overdose,” Downs said. 

Fortunately, Downs says, most cases are accidental dosing errors, and people only experience mild to moderate stomach problems. 

What are common GLP-1 side effects? How are these different than symptoms caused by an excessive amount of the medication?  

Side effects can happen with any medication. For GLP-1s, Downs and Wolver note that symptoms tend to be mild and often improve as your body adjusts to the medication. 

Most GLP-1 side effects are linked to stomach issues. Other common symptoms include:  

• Nausea 
• Vomiting 
• Diarrhea 
• Constipation  
• Heartburn 
• Decrease in appetite  

Signs of an allergic reaction are more immediate and may occur within minutes to a few hours after taking the medication. If you’re having an allergic reaction to a GLP-1, some symptoms may include: 

• Redness or swelling at the injection site 
• Hives 
• Anaphylaxis (serious reaction that can lead to breathing issues or drop in blood pressure) 

After taking too much of a GLP-1, more severe symptoms may occur within a few hours depending on the formulation and dose received. The following symptoms are concerning, and you should contact your provider:  

• Severe abdominal pain 
• Persistent vomiting or diarrhea 
• Difficulty keeping food or fluids down 
• Dehydration, such as dark urine or little to no urine  

When should I call the poison center about a GLP-1 side effect or if I accidentally took too much? At what point should I seek emergency medical care?   

Questions related to GLP-1 medications can be answered through the Poison Help line (1-800-222-1222). The poison center can help if you got the dose wrong or are experiencing mild to moderate stomach issues. Poison center specialists can also determine if you can manage symptoms at home or if you need to seek immediate medical attention. 

“Calling or sending a message to your clinician is another option if you are experiencing milder symptoms like nausea or constipation,” Wolver said. “However, any signs of an allergic reaction –– depending on severity –– should seek emergency care.” 

If you take a GLP-1 and experience the following the symptoms, you should go to the emergency department or call 911: 

• Confusion, seizures or loss of consciousness 
• Worsening abdominal pain 
• Inability to keep down fluids 
• Significant dehydration 
• Bloody vomit or stools 
• Difficulty breathing  

Most GLP-1 dosing errors are preventable, and side effects can be mitigated with your provider’s help. 

Are there other safety concerns related to weight loss medications? 

With increased accessibility through online sources, Wolver says many people are using compounded medications that are not federally approved or contain less-studied ingredients, which raises concerns around safety and product integrity.  

While GLP-1 medications are powerful medications, Wolver advises patients to follow their doctors’ guidance to avoid misuse and other health issues.  

“Without guidance, some patients significantly reduce their food intake in pursuit of faster weight loss,” Wolver said. “In our clinic, we emphasize overall health rather than weight loss alone. Rapid, poorly nourished weight loss can increase the risk of malnutrition, vitamin deficiencies, gallbladder disease, and hair loss.” 

Wolver also notes how important it is to screen for risk of disordered eating patterns, which can help mitigate excessive dietary restrictions and help prevent medication management issues. 

“This important step is frequently overlooked, not only by some online companies but also by many clinicians prescribing these medications,” Wolver said.  

How can I avoid dosing errors with injectable GLP-1 medications?  

Both Downs and Wolver agree that it is important for patients to follow their dosing schedule and understand how to use injection devices correctly.  

 “Since different products have their own devices and concentrations, it’s important for patients to understand exactly how their device works and ask their pharmacist or healthcare provider for instructions if unclear,” Downs said.” 

“Carefully following the prescribed instructions is key,” Wolver added. “We are fortunate to have a pharmacist on our team who provides detailed education and verifies proper technique which significantly reduces the risk of errors.” 

Here are tips to avoid a dosing mistake with a GLP-1: 

• Review instructions on how to use your device. Each GLP-1 product has its own dosing system. 
• Follow the recommended dosing schedule. 
• Double-check the dose before every injection. 
• Be mindful of compounded GLP-1 medications that require a syringe – incorrect measurements can lead to significant overdoses. 
• Store medications separately. 
• Don’t adjust the dose without your provider’s oversight. Increasing the dose too quickly may increase side effects.  

If you have any questions or concerns after taking a GLP-1 medication, contact the Virginia Poison Center at VCU via the Poison Help line at 1-800-222-1222. If you are a patient with the VCU Health Weight Loss Program, contact your provider with any questions about side effects or dosing.

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