Published: 26 January 2025
Safety Information
Monitoring communication
Glucagon-like peptide-1 receptor agonists (dulaglutide, liraglutide, semaglutide, tirzepatide) and acute persistent visual loss – monitoring closes 26 July 2026
26 January 20266
Monitoring closes 26 July 2026
Medsafe is reviewing the risk of acute persistent visual loss in individuals using glucagon-like peptide-1 receptor agonists, also referred to as GLP-1 receptor agonists.
We encourage healthcare professionals and consumers to report any suspected acute persistent visual loss associated with use of GLP-1 receptor agonists. Anyone can submit a report.
Products affected
More information
Medsafe's actions
Reporting adverse events
Products affected
Table 1 shows the GLP-1 receptor agonists that are approved in New Zealand, along with the approved indications for use and the sponsors.Table 1: Glucagon-like peptide-1 (GLP-1) receptor agonist products approved in NZ
| Product name | Active ingredient | Indication | Sponsor |
|---|---|---|---|
| Trulicity | dulaglutide |
Glycaemic controla
Reduce the risk of major adverse cardiovascular eventsa |
Eli Lilly and Company (NZ) Limited |
| Saxenda | liraglutide | Weight management | Novo Nordisk Pharmaceuticals Ltd |
| Victoza | liraglutide |
Glycaemic controla
Prevention of cardiovascular eventsa |
Novo Nordisk Pharmaceuticals Ltd |
| Wegovy | semaglutide |
Weight management
Prevention of cardiovascular events |
Novo Nordisk Pharmaceuticals Ltd |
| Ozempicb | semaglutide | Glycaemic controla | Novo Nordisk Pharmaceuticals Ltd |
| Mounjaro | tirzepatide |
Glycaemic controla
Weight management |
Eli Lilly and Company (NZ) Limited |
- For individuals with type 2 diabetes mellitus
- Not currently marketed/available
More information
Serious eye disorders that can cause vision loss include conditions such as retinal vein occlusion (due to thromboembolism), giant cell arteritis (GCA), optic neuritis, and non-arteritic anterior ischaemic optic neuropathy (NAION) [1].
Retinal vein occlusion commonly occurs due to thrombosis within the retinal vein. GCA is an inflammatory disease affecting medium and large arteries, particularly in the head, and can lead to sudden vision loss through occlusion of the posterior ciliary arteries. Optic neuritis involves inflammation of the optic nerve, disrupting vision signal transmission. Each of these conditions impairs blood flow or neural conduction, resulting in vision loss that may be temporary or permanent, depending on the underlying cause and timely intervention. [1]
NAION is an eye condition that typically results in severe and irreversible visual loss. Although the exact pathogenesis remains unclear, it is believed to involve impaired blood perfusion of the optic nerve head, leading to ischaemic damage. [2]
Risk factors for developing NAION include high or low blood pressure, male sex, type 2 diabetes, high cholesterol, obstructive sleep apnoea, smoking and certain medicines [2, 3]. NAION is rare, with an estimated incidence of 2 to 10 cases per 100,000 persons [4], and while it can occur at any age, it is more common in individuals over 50 years [3].
Currently, the New Zealand data sheets for GLP-1 receptor agonists do not list NAION or other forms of persistent visual loss as adverse effects. However, some data sheets include warnings about the potential risk of temporary worsening of diabetic retinopathy associated with rapid improvement in glucose control.
As of 1 December 2025, the New Zealand Pharmacovigilance Database has received two reports of patients taking GLP-1 receptor agonists who developed sudden vision loss. The first report (NZ-Medsafe-163768) concerns a female patient who experienced flashing and partial loss of vision in their left eye (diagnosed as NAION) within weeks of starting semaglutide. The second report (NZ-Medsafe-164202) describes a female patient who was diagnosed with central retinal vein occlusion within weeks of starting semaglutide .
See the consumer medicine information (CMI) and data sheet for advice on how to take these medicines and the known side effects.
Search for consumer medicine information and data sheets
Medsafe’s actions
We are placing this safety concern on the Medicines Monitoring (
) scheme to encourage reporting of sudden vision loss in one or both eyes in patients taking GLP-1 receptor agonists.
Reporting adverse events
Please report adverse events to medicines (side effects). Anyone can submit a report.
Medsafe cannot give advice about an individual’s medical condition. If you have concerns about a medicine you are taking, please talk to your health professional.
References
- 1. Feroze K, Gurnani B and O'Rourke M. 2025. Transient Loss of Vision. StatPearls URL:https://www.ncbi.nlm.nih.gov/books/NBK430845/, URL: https://www.ncbi.nlm.nih.gov/books/NBK430845/: (accessed 9 December 2025).
- 2. Grauslund J, Taha AA, Molander LD, et al. 2024. Once-weekly semaglutide doubles the five-year risk of nonarteritic anterior ischemic optic neuropathy in a Danish cohort of 424,152 persons with type 2 diabetes. International Journal of Retina and Vitreous 10(1): 97. DOI: 10.1186/s40942-024-00620-x (accessed 2 December 2025).
- 3. Dworak DP and Nichols J. 2014. A review of optic neuropathies. Disease-a-Month 60(6): 276-281. DOI: https://doi.org/10.1016/j.disamonth.2014.03.008 (accessed 2 December 2025).
- 4. Hathaway JT, Shah MP, Hathaway DB, et al. 2024. Risk of Nonarteritic Anterior Ischemic Optic Neuropathy in Patients Prescribed Semaglutide. JAMA Ophthalmology 142(8): 732-739. DOI: 10.1001/jamaophthalmol.2024.2296 (accessed 2 December 2025).
