When to seek help after using retatrutide

If you have injected any product sold as retatrutide and something feels wrong, this page tells you who to contact and how quickly. It is organised by urgency. When in doubt, go up a level, not down. You will not be in trouble for having used it.

Call 999 or go to A&E now

These are emergencies. Do not drive yourself; ask someone to take you or call an ambulance.

• Sepsis from an infected injection site or a contaminated product. The NHS says to call 999 or go to A&E if you are acting confused or have slurred speech, blue, grey, pale or blotchy skin, lips or tongue, a rash that does not fade when you roll a glass over it, difficulty breathing or breathing very fast, or you feel very unwell and are worried it might be sepsis.^[4] Infection risk from injecting non-sterile products is covered on injectables and infection.
• Anaphylaxis, a severe allergic reaction to the product or anything in it: swelling of the lips, mouth, throat or tongue, struggling to breathe, wheezing, a tight throat, feeling faint, or skin that goes pale or blue.^[5] It starts within minutes.
• Severe hypoglycaemia (low blood sugar). Counterfeit weight-loss pens in the UK have been found to contain insulin instead of the labelled drug, and people who received them, including people without diabetes, were hospitalised with hypoglycaemic shock.^[6] Warning signs are sweating, shaking, hunger, a fast heartbeat, confusion and blurred vision; severe low blood sugar can cause a seizure or unconsciousness.^[7] If you do not have diabetes and get these symptoms after injecting, that is a 999 call.
• Pancreatitis. Sudden, severe tummy pain that is spreading to your back, or comes with bloating that will not settle, a fast heartbeat or difficulty breathing.^[8] More on the pancreatitis page.
• Severe dehydration. Vomiting or diarrhoea with drowsiness, confusion, a fit, or blue, grey or blotchy skin.^[9]
• Heart. Chest pain, collapse or fainting, or a racing or irregular heartbeat with breathlessness or feeling faint. See heart rate and rhythm.
• Mental-health emergency. If you have seriously harmed yourself or feel you might act on thoughts of ending your life, call 999 or go to A&E.^[10]

Contact NHS 111 today

Call 111 or use 111 online when you are unwell and need advice the same day but it is not a 999 emergency.^[1]

• Signs of liver injury. Unusual tiredness, tummy pain, itchy skin, dark urine, yellow eyes or skin, or bruising easily. These were the symptoms in the Australian liver-injury cluster in people using products labelled retatrutide, and the health alert said to seek medical attention promptly.^[11] If you are visibly yellow, do not wait for a GP appointment. See liver and kidney.
• Dehydration that is not settling. Unusually tired, dizzy on standing and it does not pass, dark urine, or passing less urine than normal.^[9]
• Tummy pain that keeps coming back, or comes with a temperature or shivering.^[8]
• An injection site that is red, hot, swollen, spreading, or leaking pus, or a fever after injecting, before it becomes sepsis.
• Palpitations or an irregular heartbeat that has settled but was frightening.
• Severe dysesthesia: burning, tingling or numbness that is getting worse, spreading, or affecting your balance or grip. See dysesthesia.
• Urgent mental-health support. Call 111 and select the mental health option, or ask for an urgent GP appointment; 111 can put you through to a trained mental-health professional.^[10] Samaritans are free, any time, on 116 123.^[12]

See a GP this week

For anything persistent or worrying that is not urgent. Typical reasons after using a product of this kind:

• nausea, vomiting or diarrhoea that keeps going, or constipation that will not shift, covered on the gut effects page;
• tingling, burning or oversensitive skin that is mild but persistent;
• a resting pulse that is noticeably faster than usual;
• feeling low, anxious or not yourself;
• losing weight faster than feels safe, or being unable to eat;
• wanting blood tests for your liver, kidneys and pancreas, which is a reasonable request after using an unlicensed product.

The talking to your GP page explains how to have that conversation. It is easier than most people expect.

Report it: Yellow Card, always

The MHRA's Yellow Card scheme accepts reports of suspected side effects from any medicine, including unlicensed and counterfeit products, from members of the public as well as professionals.^[2] Reports about unlicensed products are exactly the ones the regulator most needs, because there is no manufacturer collecting them. You can report online in a few minutes. See reporting a reaction.

What to tell the clinician

Clinicians can only treat what they know about. Tell them, in this order:

1. What you injected: the name on the label, and that it was an unlicensed product bought online or from a contact, not a prescription.
2. When: the date and time of the last injection, and how long you have been using it.
3. How much: the amount you injected, as best you can, and how much was left in the vial or pen.
4. Any other medicines you take, including anti-sickness tablets. One severe heart-rhythm event in retatrutide's Phase 2 trial involved a participant who was also taking ondansetron.^[13]
5. Your symptoms, in the order they started.

Take the vial or pen with you, and any packaging. It tells the clinician what you thought you were taking, and it can be tested. In Australia it was analysis of exactly such a vial that revealed a product at nearly double the labelled strength.^[14]

Why this page exists

Trial participants had a study nurse to ring. People using products sold online have nobody, and the products themselves can contain the wrong dose, a different drug, or a contaminant. Trial side-effect rates describe the trial product; an unlicensed product carries unknown extra risks. This page is the closest thing to a study nurse that we can offer. The side effects hub covers each effect in detail.