Two hundred and forty-seven people are lined up in Philadelphia, suing over the same drug. They say that after getting the shot, they could no longer see. The US prescribing information for this drug doesn’t say a single word about it.
It’s blank.
The drug is semaglutide, made by Novo Nordisk. The injection is called Ozempic; the weight-loss version is Wegovy. Eli Lilly’s tirzepatide is also in the dock. Plenty of people in China are using these as weight-loss shots without even looking through those few pages.
Most people assume that if the information leaflet doesn’t mention it, it probably doesn’t happen. That might be true for other things. It isn’t true for this drug.
In June 2025, the European Medicines Agency acknowledged that non-arteritic anterior ischemic optic neuropathy is a very rare side effect of this drug, occurring in fewer than one in 10,000 people, with the relative risk roughly doubled. That same month, the World Health Organization issued an alert. In February this year, the UK drug regulator added it to the product information, along with an instruction to stop the drug if the condition is diagnosed. Australia’s July warning covered several drugs: semaglutide, tirzepatide, liraglutide, and dulaglutide. It called the risk rare but serious, and said it could cause permanent vision damage, including blindness.
In the US, though, the label is still blank. It was revised this May, but all it tells patients is, “Tell your doctor if you experience changes in your vision.” The letters NAION don’t appear. One leaflet says it. The other is blank. Both sides of the Atlantic got the same data. How can that be?
It’s not as simple as saying, “Nobody’s stopping them from adding it.” There are plenty of things in the way. Put it in writing, and you’re admitting it. Once you admit it, the bills come due.
There’s one number I’ve been staring at for a long time. According to the UK Yellow Card system, from the drug’s approval in 2018 through August 2025, it received a total of three spontaneous reports of suspected optic nerve disorders. During that same period, around ten million packs were distributed in the UK. At a rate of one in 10,000, there should have been a thousand reports.
Three and a thousand.
That’s a difference of two orders of magnitude. Nobody has a clear answer for where the gap comes from. This system misses a lot: patients don’t know they should report, and doctors can’t be bothered. There has never been a reliable figure for the global underreporting rate. These three reports don’t prove the drug is safe, and they don’t prove it’s dangerous. They show just one thing: nobody is counting carefully.
In Philadelphia, two cases are moving forward side by side. There are 4,025 gastroparesis cases and 247 optic nerve cases, before the same judge. The two groups are moving in opposite directions. In September, the stomach group added only three new cases, compared with 80 or 90 a month over the previous two years. The vision group went the other way, rising from 216 to 247 in a month. All the lawyers are waiting for a ruling, waiting for the judge to answer one question first: can this drug cause this condition?
That question should be answered by regulators. Now it’s scheduled for August 2027.
I spent a long time wondering what comparison to use. Then I realized the key isn’t the drug. It’s who gets to write those three words: “the information leaflet.”
From the first version of a drug’s leaflet to the one that ends up in a patient’s hands, how many times was it changed, why was each change made, and what was quietly removed in which version? Patients don’t have that record. The drug company does. The regulator does. The seller does. The person who buys and takes the drug doesn’t. And nobody seems to intend to show it to them.
That happens to be one of the least appreciated features of a blockchain. Every version of a smart contract, from deployment to the present, the block where each version took effect, and who signed off on it—all of it is posted online for anyone to inspect. It can’t guarantee the code is well written, or that nobody will be scammed. It guarantees just one thing: if something was changed, it was changed. It can’t be erased. People have been moving records from the outside world onto blockchains for a long time; mostly, though, they’ve been moving prices and balances.
If the drug industry had a record like that, those 247 people wouldn’t have to spend two years proving, “You knew all along.”
If someone in your family is taking this shot, take a look at the information leaflet in the box and check the date printed on it. That line of fine print is more direct than any explainer article.
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#司美格鲁肽 #GLP1 #减肥针 #DrugRegulation
It’s blank.
The drug is semaglutide, made by Novo Nordisk. The injection is called Ozempic; the weight-loss version is Wegovy. Eli Lilly’s tirzepatide is also in the dock. Plenty of people in China are using these as weight-loss shots without even looking through those few pages.
Most people assume that if the information leaflet doesn’t mention it, it probably doesn’t happen. That might be true for other things. It isn’t true for this drug.
In June 2025, the European Medicines Agency acknowledged that non-arteritic anterior ischemic optic neuropathy is a very rare side effect of this drug, occurring in fewer than one in 10,000 people, with the relative risk roughly doubled. That same month, the World Health Organization issued an alert. In February this year, the UK drug regulator added it to the product information, along with an instruction to stop the drug if the condition is diagnosed. Australia’s July warning covered several drugs: semaglutide, tirzepatide, liraglutide, and dulaglutide. It called the risk rare but serious, and said it could cause permanent vision damage, including blindness.
In the US, though, the label is still blank. It was revised this May, but all it tells patients is, “Tell your doctor if you experience changes in your vision.” The letters NAION don’t appear. One leaflet says it. The other is blank. Both sides of the Atlantic got the same data. How can that be?
It’s not as simple as saying, “Nobody’s stopping them from adding it.” There are plenty of things in the way. Put it in writing, and you’re admitting it. Once you admit it, the bills come due.
There’s one number I’ve been staring at for a long time. According to the UK Yellow Card system, from the drug’s approval in 2018 through August 2025, it received a total of three spontaneous reports of suspected optic nerve disorders. During that same period, around ten million packs were distributed in the UK. At a rate of one in 10,000, there should have been a thousand reports.
Three and a thousand.
That’s a difference of two orders of magnitude. Nobody has a clear answer for where the gap comes from. This system misses a lot: patients don’t know they should report, and doctors can’t be bothered. There has never been a reliable figure for the global underreporting rate. These three reports don’t prove the drug is safe, and they don’t prove it’s dangerous. They show just one thing: nobody is counting carefully.
In Philadelphia, two cases are moving forward side by side. There are 4,025 gastroparesis cases and 247 optic nerve cases, before the same judge. The two groups are moving in opposite directions. In September, the stomach group added only three new cases, compared with 80 or 90 a month over the previous two years. The vision group went the other way, rising from 216 to 247 in a month. All the lawyers are waiting for a ruling, waiting for the judge to answer one question first: can this drug cause this condition?
That question should be answered by regulators. Now it’s scheduled for August 2027.
I spent a long time wondering what comparison to use. Then I realized the key isn’t the drug. It’s who gets to write those three words: “the information leaflet.”
From the first version of a drug’s leaflet to the one that ends up in a patient’s hands, how many times was it changed, why was each change made, and what was quietly removed in which version? Patients don’t have that record. The drug company does. The regulator does. The seller does. The person who buys and takes the drug doesn’t. And nobody seems to intend to show it to them.
That happens to be one of the least appreciated features of a blockchain. Every version of a smart contract, from deployment to the present, the block where each version took effect, and who signed off on it—all of it is posted online for anyone to inspect. It can’t guarantee the code is well written, or that nobody will be scammed. It guarantees just one thing: if something was changed, it was changed. It can’t be erased. People have been moving records from the outside world onto blockchains for a long time; mostly, though, they’ve been moving prices and balances.
If the drug industry had a record like that, those 247 people wouldn’t have to spend two years proving, “You knew all along.”
If someone in your family is taking this shot, take a look at the information leaflet in the box and check the date printed on it. That line of fine print is more direct than any explainer article.
$BTC $ETH $LINK
#司美格鲁肽 #GLP1 #减肥针 #DrugRegulation