Rita Karam, an official at Lebanon's Ministry of Public Health, said officials suspected the injections they had taken were adulterated after discovering that their doses differed from those of the original Uzambik injection pens.

Reuters interviews with law enforcement, anti-fraud and public health officials last month showed that a huge number of counterfeit injections had been detected due to the growing demand for Uzambik and other weight-loss drugs, including Eli Lilly's Mongaro and Novo's Wegovi.

Authorities have already found the counterfeit Uzmbek products in at least 17 countries, including Britain, Germany, Egypt and Russia.

Several countries have asked pharmacies and consumers to be wary of counterfeit products because their ingredients are unclear.

Rita said the ministry had begun investigating the eleven cases but could not identify the sources of the drugs or the numbers printed on their labels, allowing traceability of their production history, making it difficult to know what the patients had originally ingested.

Three of them used the suspected adulterated drug Uzembek to control diabetes, four used it to control weight and the remaining four used it for unspecified reasons, it said.

People with diabetes need to control their blood sugar well, which can be done with a variety of medications including Uzembek.

When the blood glucose level drops sharply they can suffer from low blood sugar with symptoms that may include headache or dorria and symptoms can progress to loss of consciousness or seizures.

Withdrawal from the markets

According to the ministry's website, two orders related to the withdrawal of Uzembek were issued in January 2023. Rita said there were no reported cases of possible non-genuine injection use from Uzambik in Lebanon last year.

Novo Nordisk said it investigates every case of fraud it finds in its products and reports it to local authorities, and that it has developed a guide for healthcare providers in the Middle East to explain how to detect counterfeit medicines.

More than a quarter of adults in Lebanon are obese, according to the World Obesity Federation figures for 2017. Obesity is closely linked to type II diabetes, the most common form of the disease.

Data from the International Diabetes Federation showed that nearly nine percent of adults in Lebanon developed diabetes in 2021, compared to about 14 percent in the United States.

Rita Karam said the Ministry of Health does not buy or provide the drug Uzambik.

Insulin instead of active substance

A final phase of trials showed that Novo Nordisk's weight-loss drug Wujovi, which contains the same active ingredient as Uzembek, semaglutide, helps patients lose 15 percent of their weight on average.

The scramble for supplies of the weight-lowering substance has led to shortages in several countries such as Britain, Germany, Belgium and the United States.

A source familiar with anti-fraud efforts told Reuters last month that markets with widespread sales of counterfeit weight loss drugs included Lebanon and other Middle Eastern countries.

Several people were hospitalized in Austria with low blood sugar after taking possible Uzambik falsified drugs.

The health safety regulator there said side effects suggested the product contained insulin instead of semaglutide.

Last month, Belgium's medicines regulator said it had seized counterfeit copies of Uzembek and confirmed that the pens contained insulin.