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GLP-1 药物（Ozempic、Wegovy）与您的手术

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If you take a GLP-1 medication (such as semaglutide — Ozempic or Wegovy) and you are having an operation: what these drugs do, why they matter for your anaesthetic (delayed stomach emptying and aspiration risk), and what you should do before surgery.

Updated Jul 2026
一种医疗注射笔。
GLP-1 类药物日益普及，其在手术和麻醉前具有值得讨论的影响。 Kieran Hirpara 4.0

本页面由机器翻译，尚未经临床医生审核。英文版本为权威版本。

您的感受

在准备手术期间，您可能会注意到身体感觉有所不同。许多患者发现，在手术前使用 GLP-1 类药物有助于减轻体重。这可以使手术更容易进行，恢复过程更顺利。随着体重下降，您可能会感到精力更充沛。然而，这些药物也会改变胃的功能。它们会减缓消化速度。这意味着食物在胃中停留的时间比平时更长。

由于消化速度变慢，您可能在进食少量食物后很快就有饱腹感。您可能会出现恶心或腹部沉重感。有些人会注意到烧心或胃酸倒流。在开始服药或增加剂量时，这些症状很常见。它们通常发生在餐后。如果您吃得太快或选择油腻、高脂肪的食物，您可能会感到不适。

您的外科医生将指导您是否在手术前停用这些药物。目前的证据不建议提前停药，因为这可能导致血糖飙升和体重反弹。相反，您的护理团队将仔细管理停药时间。这有助于在愈合过程中保持体重稳定并控制血糖。

手术后，您可能会想知道这些药物如何影响您的愈合。研究表明，在关节置换术前后使用 GLP-1 类药物并不会增加术后 90 天或两年内并发症的风险。事实上，一些研究表明感染和再入院的风险较低。您可能愈合得更快，并减少医院资源的使用。

然而，这些药物可能会影响骨骼健康。某些类型可能会增加骨折的风险。在这些药物中，艾塞那肽（Exenatide）被认为是对骨骼强度最安全的选项。您的外科医生将密切监测您的骨骼。如果您患有骨关节炎（退行性关节炎），您的医生将密切关注任何变化。这确保您在恢复活动能力时关节保持强壮。

您可能会对这些变化感到焦虑。担心药物与手术的相互作用是正常的。请记住，您的团队对此有经验。他们将根据您的身体状况量身定制计划。专注于遵循他们的饮食和服药时间指示。这有助于您在整个过程中保持安全和舒适。

实际发生了什么

您的身体正在使用这些药物来帮助管理体重和血糖。它们通过减缓胃排空食物的速度来发挥作用。这能让您更长时间地保持饱腹感，并帮助身体更好地处理葡萄糖。对于许多患者来说，这是手术前的一种有益工具。它可能带来关节置换术后更好的早期结果，并可能降低需要再次住院的风险。

然而，这种较慢的消化过程会改变身体对麻醉和恢复的处理方式。由于食物在胃中停留时间更长，手术期间胃内容物反流的风险更高。这就是为什么您的外科医生需要知道您正在服用这些药物。这使他们能够安全地规划您的护理。不建议自行停药。这样做会导致血糖飙升，并使体重控制变得更加困难。

这些药物也以复杂的方式与您的骨骼和关节相互作用。它们可能为某些糖尿病患者提供一定的抗骨丢失保护。然而，它们对关节健康的长期影响仍在研究中。一些数据表明，它们可能会降低髋关节或膝关节手术后的感染风险。其他研究结果则不一。您的外科医生将权衡这些益处与风险。他们希望确保您的骨骼和关节在手术前尽可能强壮。

目标是保持您的稳定。除非您的外科医生告知，否则您不应在手术前停止服用处方剂量。突然的变化可能对您的健康造成的伤害比手术本身更大。您的医疗团队将指导您最佳的时间安排。这确保您获得体重和血糖方面的益处，同时不增加手术风险。

预期情况

在准备手术期间，您可能会注意到身体发生一些变化。GLP-1 类药物有助于减重和控制血糖。这些工具可以改善关节置换术后的早期恢复。您可能会减少住院次数，减轻医疗资源的负担。一些数据还表明，这些药物与髋关节或膝关节手术后感染风险降低有关。

您的外科医生可能会让您继续服用您的药物。不建议在手术前停药。目前没有足够的证据表明停药有益。相反，停药可能导致高血糖和体重增加。这使得健康管理变得更加困难。您的医疗团队希望保持您的体重和血糖稳定。

您应该知道，结果并非对所有人都一样。关于这些药物的研究仍在不断深入。虽然许多患者效果良好，但一些研究结果显示不一。我们需要更多高质量的研究来充分了解在手术期间使用这些药物的最佳方式。

骨骼健康是另一个需要考虑的方面。这些药物会影响您身体处理骨骼的方式。与其他同类药物相比，艾塞那肽（Exenatide）可能具有较低的骨折风险。目前也在持续调查这些药物是否与新的骨关节炎（磨损性关节炎）病例有关。这是一个复杂的领域，您的外科医生将密切监测。

总体而言，对于使用这些工具管理体重和糖尿病的患者，前景通常是积极的。您可能会更顺利地完成手术过程。您可能会面临更少的并发症，并更快地回归日常生活。您的外科医生将根据您的具体需求制定个性化方案。请按照指示继续服药。如有任何变化，请及时告知您的医疗团队。这种方法有助于实现手术的最佳结果。

Reviewed by Kieran Hirpara · 13 June 2026.

Want the clinical detail? Read the clinician version.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

  • GLP-1 receptor agonists induce delayed gastric emptying, which has implications for perioperative aspiration risk during anesthesia [1].
  • The increasing prevalence of GLP-1 receptor agonist use in patients with obesity presents a new challenge for anesthesiologists [2].
  • High-quality studies are needed to determine optimal perioperative care for patients on GLP-1 receptor agonists [2].
  • GLP-1 receptor agonists show potential to reduce postoperative complications in total joint arthroplasty, but findings remain inconsistent [3].
  • Further research is needed to clarify the impact of GLP-1 receptor agonists on surgical outcomes and establish perioperative management guidelines [3].
  • Conflicting findings regarding the impact of GLP-1 receptor agonists on postoperative outcomes in arthroplasty highlight the need for well-designed multicenter studies and randomized controlled trials [4].
  • Arthroplasty surgeons will encounter an increasing number of patients on GLP-1 agonists, necessitating an understanding of their perioperative implications [5].
  • GLP-1 receptor agonist therapy is not associated with adverse events following shoulder surgery [6].
  • GLP-1 agonist use should not be a contraindication for proceeding with total shoulder arthroplasty [6].
  • Elective preprocedural cessation of GLP-1 receptor agonists and GLP-1/GIP receptor agonists is not recommended due to insufficient data supporting cessation and risks of hyperglycemia and compromised weight control [7].
  • Variability in available studies, potential confounding factors, and severe heterogeneity of conclusions emphasize the need for more high-quality evidence-based primary research to optimize perioperative management of patients taking GLP-1 receptor agonists [8].
  • Narrative reviews explore the mechanisms of action of GLP-1 agonists, their effects on bone health, and their implications in perioperative patients undergoing orthopedic surgery, with an emphasis on spine surgery [9].
  • Semaglutide and other GLP-1 agonists may increase the number of eligible candidates for elective total joint arthroplasty by enabling weight loss and improving diabetic control [10].
  • Semaglutide and other GLP-1 agonists may potentially reduce postoperative complications such as sepsis and prosthetic joint infections [10].
  • GLP-1 receptor agonist use suggests a potential benefit for optimizing high-risk patients with obesity or diabetes undergoing total joint arthroplasty [11].
  • GLP-1 receptor agonists may provide skeletal benefits in type 2 diabetes patients by addressing specific mechanisms underlying diabetic osteopathy [16].
  • The effects of GLP-1 receptor agonists on diabetic osteopathy vary by agent type, patient characteristics, and treatment duration [16].
  • Further investigation is needed to elucidate the association between GLP-1 receptor agonist use and the increased incidence of osteoarthritis diagnosis and conversion to total knee arthroplasty in patients with no preexisting osteoarthritis [19].

Effects on Surgery and Recovery

  • Interdisciplinary collaboration between endocrinologists and anesthesiologists is important to ensure safe and individualized perioperative management of patients on GLP-1 RAs [1].
  • High-quality studies are needed to address the optimal perioperative care of patients on GLP-1RAs [2].
  • Further research is needed to clarify the impact of GLP-1 receptor agonists on outcomes and establish perioperative management guidelines for total joint arthroplasty [3].
  • Conflicting findings regarding the effects of GLP-1 RAs on surgical outcomes highlight the need for well-designed multicenter studies and randomized controlled trials [4].
  • GLP-1 agonist use should not be a contraindication for proceeding with total shoulder arthroplasty (TSA) [6].
  • Elective preprocedural cessation of GLP-1RAs and GLP-1/GIPRAs is not recommended due to insufficient data supporting cessation and risks of hyperglycemia and compromised weight control [7].
  • Variability in available studies, potential confounding factors, and severe heterogeneity of conclusions emphasize the need for more high-quality evidence-based primary research to optimize perioperative management of patients taking GLP-1 RAs [8].
  • Semaglutide and other GLP-1 agonists may reduce postoperative complications such as sepsis and prosthetic joint infections in total joint arthroplasty [10].
  • GLP-1RA use has a potential benefit for optimizing high-risk patients with obesity or diabetes undergoing total joint arthroplasty [11].
  • Preoperative glucagon-like peptide-1 receptor agonist use may be linked to reduced readmission risk following joint arthroplasty [12].
  • Preoperative glucagon-like peptide-1 receptor agonist use is not associated with evidence of increased postoperative medical harm following joint arthroplasty [12].
  • Current observational data suggest that perioperative GLP-1 RA use in patients undergoing total hip or knee arthroplasty is not associated with a consistent increase in short-term revision rates [13].
  • Perioperative GLP-1 RA use in patients undergoing total hip or knee arthroplasty may be associated with a reduced risk of postoperative infection [13].
  • Extended GLP-1 RA withholding, 24-hour clear liquid diets, and pre-procedural gastric POCUS may be associated with reduced residual gastric content in selected patient populations [14].
  • Perioperative GLP-1RA use was associated with a small yet statistically significant reduction in the odds of wound dehiscence following carpal tunnel release (CTR) [15].
  • Perioperative GLP-1RA use did not increase the odds of any other 90-day postoperative complications following carpal tunnel release [15].
  • Exenatide is the best option agent with regard to the risk of fracture among GLP-1 receptor agonists [17].
  • GLP-1 receptor agonists are a promising tool for preoperative weight loss in patients with obesity and type-2 diabetes mellitus undergoing orthopaedic surgery [18].

Practical Considerations

  • The increasing prevalence of GLP-1 RA use in patients with obesity presents a new challenge for anesthesiologists regarding perioperative care [2].
  • High-quality studies are needed to address the optimal perioperative care of patients on GLP-1 RAs [2].
  • Further research is needed to clarify the impact of GLP-1 RAs on outcomes and establish perioperative management guidelines for total joint arthroplasty [3].
  • Conflicting findings regarding the effects of GLP-1 RAs on surgical outcomes highlight the need for further research, including well-designed multicenter studies and randomized controlled trials [4].
  • Elective preprocedural cessation of GLP-1 RAs and GLP-1/GIP RAs is not recommended due to insufficient data supporting cessation and the risks of hyperglycemia and compromised weight control [7].
  • Narrative reviews explore the mechanisms of action of GLP-1 agonists, their effects on bone health, and their implications for perioperative patients undergoing orthopedic surgery, with an emphasis on spine surgery [9].
  • GLP-1 RA use may benefit high-risk patients with obesity or diabetes undergoing total joint arthroplasty [11].
  • Preoperative GLP-1 receptor agonist use may be linked to reduced readmission risk following joint arthroplasty [12].
  • Preoperative GLP-1 receptor agonist use is not associated with evidence of increased postoperative medical harm in joint arthroplasty [12].

Key Evidence

  • [L4] This review summarizes the pharmacological mechanisms and clinical implications of GLP-1 RA-induced delayed gastric emptying, evaluates current literature on perioperative aspiration risk, and emphasizes the importance of interdisciplinary collaboration between endocrinologists and anesthesiologists to ensure safe and individualized perioperative management. [1] (10.3904/kjim.2025.277)
  • [L4] Due to the increasing popularity of GLP-1RAs in patients with obesity, the authors call for further high-quality studies to address the optimal perioperative care of patients on GLP-1RAs. [2] (10.5114/ait/203167)
  • [L5] The paper concludes that while GLP-1 receptor agonists show potential to reduce postoperative complications in total joint arthroplasty, findings remain inconsistent, and further research is needed to clarify their impact on outcomes and establish perioperative management guidelines. [3] (10.1016/j.arth.2025.10.027)
  • [L4] However, conflicting findings highlight the need for further research, particularly well-designed multicenter studies and randomized controlled trials, to clarify the effects of GLP-1 RAs on surgical outcomes. [4] (10.1016/j.arth.2025.07.015)
  • [L5] Arthroplasty surgeons will encounter an increasing number of patients on GLP-1 agonists, making it important to understand the implications of their use in the perioperative period. [5] (10.1016/j.arth.2023.12.002)
  • [L1] Based on this data, GLP-1 agonist use should not be a contraindication for proceeding with TSA. [6] (10.1016/j.jse.2025.12.005)
  • [L2] The variability in available studies, potential confounding factors, and the severe heterogeneity of conclusions all emphasize the need for more high-quality evidence-based primary research to optimize perioperative management of patients taking GLP-1 RAs. [8] (10.1186/s13741-026-00662-9)
  • [L4] This narrative review explores the mechanisms of action of GLP-1 agonists, their effects on bone health, and the implications of their use in perioperative patients undergoing orthopedic surgery, with an emphasis on spine surgery. [9] (10.1177/15563316261438492)
  • [L5] Semaglutide and other GLP-1 agonists may increase the number of eligible candidates for elective total joint arthroplasty by enabling weight loss and improving diabetic control, while also potentially reducing postoperative complications such as sepsis and prosthetic joint infections. [10] (10.1016/j.arth.2023.12.014)
  • [L1] These findings suggest a potential benefit of GLP-1RA use for optimizing high-risk patients who have obesity or diabetes undergoing total joint arthroplasty. [11] (10.1016/j.arth.2025.09.054)
  • [L1] Preoperative glucagon-like peptide-1 receptor agonist use may be linked to reduced readmission risk following joint arthroplasty, without evidence of increased postoperative medical harm. [12] (10.1016/j.arth.2025.11.036)
  • [L4] Current observational data suggest that perioperative GLP-1 RA use in patients undergoing total hip or knee arthroplasty is not associated with a consistent increase in short-term revision rates and may be associated with a reduced risk of postoperative infection. [13] (10.1186/s42836-026-00375-w)
  • [L4] Available observational evidence suggests that extended GLP-1 RA withholding, 24-hour clear liquid diets, and pre-procedural gastric POCUS may be associated with reduced residual gastric content in selected patient populations. [14] (10.7759/cureus.108216)
  • [L3] Perioperative GLP-1RA use was associated with a small yet statistically significant reduction in the odds of wound dehiscence following CTR and did not increase the odds of any other 90-day postoperative complications. [15] (10.1016/j.jhsg.2025.100746)
  • [L1] GLP-1 RAs may provide skeletal benefits in T2DM patients by addressing specific mechanisms underlying diabetic osteopathy, with effects varying by agent type, patient characteristics, and treatment duration. [16] (10.1186/s12891-025-09022-y)
  • [L1] Exenatide is the best option agent with regard to the risk of fracture. [17] (10.1007/s00198-018-4649-8)
  • [L5] GLP-1 receptor agonists are a promising tool for preoperative weight loss in patients with obesity and type-2 diabetes mellitus undergoing orthopaedic surgery. [18] (10.2106/jbjs.24.01287)
  • [L3] Further investigation is needed to elucidate the association between GLP-1-RA use and the increased incidence of OA diagnosis and conversion to TKA in patients with no preexisting OA. [19] (10.1177/23259671241297157)

References

[1] Delayed gastric emptying induced by glucagon-like peptide-1 receptor agonists and its implications for perioperative risk during anesthesia. The Korean Journal of Internal Medicine. 2026. DOI: 10.3904/kjim.2025.277

[2] GLP-1 agonists: a new hope for patients, a new challenge for anaesthetists. Anaesthesiology Intensive Therapy. 2025. DOI: 10.5114/ait/203167

[3] Glucagon-Like Peptide-1 Receptor Agonists: Have We Found the Holy Grail for Total Joint Arthroplasty?. The Journal of Arthroplasty. 2025. DOI: 10.1016/j.arth.2025.10.027

[4] Impact of Glucagon-Like Peptide-1 Receptor Agonists on Postoperative Outcomes in Arthroplasty: A Systematic Review. The Journal of Arthroplasty. 2025. DOI: 10.1016/j.arth.2025.07.015

[5] The Impact of Glucagon-Like Peptide-1 Agonists on Hip and Knee Arthroplasty and Perioperative Considerations. The Journal of Arthroplasty. 2024. DOI: 10.1016/j.arth.2023.12.002

[6] GLP-1 receptor agonist therapy is not associated with adverse events following shoulder surgery: a systematic review and meta-analysis. Journal of Shoulder and Elbow Surgery. 2026. DOI: 10.1016/j.jse.2025.12.005

[7] Periprocedural use of GLP-1 receptor agonists: ANZCA Clinical Practice Recommendations. ANZCA. 2025.

[8] Perioperative anesthesia management of GLP-1 receptor agonists: a systematic review of potential risks. Perioperative Medicine. 2026. DOI: 10.1186/s13741-026-00662-9

[9] GLP-1 Agonists in Orthopedic Surgery: A Narrative Review of Bone Health and Surgical Implications. HSS Journal. 2026. DOI: 10.1177/15563316261438492

[10] Semaglutide and Other GLP-1 Agonists: A Boon for the Arthroplasty Industry?. The Journal of Arthroplasty. 2024. DOI: 10.1016/j.arth.2023.12.014

[11] The Impact of Glucagon-Like Peptide-1 Receptor Agonist Use on Clinical Outcomes After Total Hip and Knee Arthroplasty: A Systematic Review and Meta-Analysis of 346,899 Patients. The Journal of Arthroplasty. 2025. DOI: 10.1016/j.arth.2025.09.054

[12] Glucagon-Like Peptide-1 Receptor Agonists, Readmission, and Postoperative Complications in Arthroplasty: A Systematic Review and Meta-Analysis. The Journal of Arthroplasty. 2025. DOI: 10.1016/j.arth.2025.11.036

[13] Glucagon-like peptide-1 receptor agonists in total joint arthroplasty: a comprehensive systematic review of what orthopaedic surgeons should know. Arthroplasty. 2026. DOI: 10.1186/s42836-026-00375-w

[14] Peri-Procedural Fasting and Gastric Ultrasound Strategies in Glucagon-Like Peptide-1 (GLP-1) Receptor Agonist Users: A Systematic Review With Qualitative Synthesis. Cureus. 2026. DOI: 10.7759/cureus.108216

[15] Impact of Perioperative Glucagon-Like Peptide-1 Receptor Agonists on Postoperative Outcomes Following Carpal Tunnel Release. Journal of Hand Surgery Global Online. 2025. DOI: 10.1016/j.jhsg.2025.100746

[16] Differential effects of GLP-1 receptor agonists on diabetic osteopathy in type 2 diabetes: a patient-stratified network meta-analysis. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-025-09022-y

[17] Glucagon-like peptide-1 receptor agonists and fracture risk: a network meta-analysis of randomized clinical trials. Osteoporosis International. 2018. DOI: 10.1007/s00198-018-4649-8

[18] GLP-1 Receptor Agonists in Orthopaedic Surgery: Implications for Perioperative Care and Outcomes. Journal of Bone and Joint Surgery. 2025. DOI: 10.2106/jbjs.24.01287

[19] The Impact of Contemporary Glucagon-like Peptide-1 Receptor Agonists on the Onset, Severity, and Conversion to Arthroplasty in Hip and Knee Osteoarthritis. Orthopaedic Journal of Sports Medicine. 2025. DOI: 10.1177/23259671241297157

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3. Term. The term of this Public License is specified in Section 6(a).

4. Media and formats; technical modifications allowed. The Licensor authorizes You to exercise the Licensed Rights in all media and formats whether now known or hereafter created, and to make technical modifications necessary to do so. The Licensor waives and/or agrees not to assert any right or authority to forbid You from making technical modifications necessary to exercise the Licensed Rights, including technical modifications necessary to circumvent Effective Technological Measures. For purposes of this Public License, simply making modifications authorized by this Section 2(a) (4) never produces Adapted Material.

5. Downstream recipients.

a. Offer from the Licensor -- Licensed Material. Every recipient of the Licensed Material automatically receives an offer from the Licensor to exercise the Licensed Rights under the terms and conditions of this Public License.

b. No downstream restrictions. You may not offer or impose any additional or different terms or conditions on, or apply any Effective Technological Measures to, the Licensed Material if doing so restricts exercise of the Licensed Rights by any recipient of the Licensed Material.

6. No endorsement. Nothing in this Public License constitutes or may be construed as permission to assert or imply that You are, or that Your use of the Licensed Material is, connected with, or sponsored, endorsed, or granted official status by, the Licensor or others designated to receive attribution as provided in Section 3(a)(1)(A)(i).

b. Other rights.

1. Moral rights, such as the right of integrity, are not licensed under this Public License, nor are publicity, privacy, and/or other similar personality rights; however, to the extent possible, the Licensor waives and/or agrees not to assert any such rights held by the Licensor to the limited extent necessary to allow You to exercise the Licensed Rights, but not otherwise.

2. Patent and trademark rights are not licensed under this Public License.

3. To the extent possible, the Licensor waives any right to collect royalties from You for the exercise of the Licensed Rights, whether directly or through a collecting society under any voluntary or waivable statutory or compulsory licensing scheme. In all other cases the Licensor expressly reserves any right to collect such royalties, including when the Licensed Material is used other than for NonCommercial purposes.

Section 3 -- License Conditions.

Your exercise of the Licensed Rights is expressly made subject to the following conditions.

a. Attribution.

1. If You Share the Licensed Material (including in modified form), You must:

a. retain the following if it is supplied by the Licensor with the Licensed Material:

i. identification of the creator(s) of the Licensed Material and any others designated to receive attribution, in any reasonable manner requested by the Licensor (including by pseudonym if designated);

ii. a copyright notice;

iii. a notice that refers to this Public License;

iv. a notice that refers to the disclaimer of warranties;

v. a URI or hyperlink to the Licensed Material to the extent reasonably practicable;

b. indicate if You modified the Licensed Material and retain an indication of any previous modifications; and

c. indicate the Licensed Material is licensed under this Public License, and include the text of, or the URI or hyperlink to, this Public License.

2. You may satisfy the conditions in Section 3(a)(1) in any reasonable manner based on the medium, means, and context in which You Share the Licensed Material. For example, it may be reasonable to satisfy the conditions by providing a URI or hyperlink to a resource that includes the required information.

3. If requested by the Licensor, You must remove any of the information required by Section 3(a)(1)(A) to the extent reasonably practicable.

4. If You Share Adapted Material You produce, the Adapter's License You apply must not prevent recipients of the Adapted Material from complying with this Public License.

Section 4 -- Sui Generis Database Rights.

Where the Licensed Rights include Sui Generis Database Rights that apply to Your use of the Licensed Material:

a. for the avoidance of doubt, Section 2(a)(1) grants You the right to extract, reuse, reproduce, and Share all or a substantial portion of the contents of the database for NonCommercial purposes only;

b. if You include all or a substantial portion of the database contents in a database in which You have Sui Generis Database Rights, then the database in which You have Sui Generis Database Rights (but not its individual contents) is Adapted Material; and

c. You must comply with the conditions in Section 3(a) if You Share all or a substantial portion of the contents of the database.

For the avoidance of doubt, this Section 4 supplements and does not replace Your obligations under this Public License where the Licensed Rights include other Copyright and Similar Rights.

Section 5 -- Disclaimer of Warranties and Limitation of Liability.

a. UNLESS OTHERWISE SEPARATELY UNDERTAKEN BY THE LICENSOR, TO THE EXTENT POSSIBLE, THE LICENSOR OFFERS THE LICENSED MATERIAL AS-IS AND AS-AVAILABLE, AND MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE LICENSED MATERIAL, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHER. THIS INCLUDES, WITHOUT LIMITATION, WARRANTIES OF TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, ABSENCE OF LATENT OR OTHER DEFECTS, ACCURACY, OR THE PRESENCE OR ABSENCE OF ERRORS, WHETHER OR NOT KNOWN OR DISCOVERABLE. WHERE DISCLAIMERS OF WARRANTIES ARE NOT ALLOWED IN FULL OR IN PART, THIS DISCLAIMER MAY NOT APPLY TO YOU.

b. TO THE EXTENT POSSIBLE, IN NO EVENT WILL THE LICENSOR BE LIABLE TO YOU ON ANY LEGAL THEORY (INCLUDING, WITHOUT LIMITATION, NEGLIGENCE) OR OTHERWISE FOR ANY DIRECT, SPECIAL, INDIRECT, INCIDENTAL, CONSEQUENTIAL, PUNITIVE, EXEMPLARY, OR OTHER LOSSES, COSTS, EXPENSES, OR DAMAGES ARISING OUT OF THIS PUBLIC LICENSE OR USE OF THE LICENSED MATERIAL, EVEN IF THE LICENSOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSSES, COSTS, EXPENSES, OR DAMAGES. WHERE A LIMITATION OF LIABILITY IS NOT ALLOWED IN FULL OR IN PART, THIS LIMITATION MAY NOT APPLY TO YOU.

c. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 -- Term and Termination.

a. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

b. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or

2. upon express reinstatement by the Licensor.

For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.

c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.

Creative Commons is not a party to its public licenses. Notwithstanding, Creative Commons may elect to apply one of its public licenses to material it publishes and in those instances will be considered the “Licensor.” The text of the Creative Commons public licenses is dedicated to the public domain under the CC0 Public Domain Dedication. Except for the limited purpose of indicating that material is shared under a Creative Commons public license or as otherwise permitted by the Creative Commons policies published at creativecommons.org/policies, Creative Commons does not authorize the use of the trademark "Creative Commons" or any other trademark or logo of Creative Commons without its prior written consent including, without limitation, in connection with any unauthorized modifications to any of its public licenses or any other arrangements, understandings, or agreements concerning use of licensed material. For the avoidance of doubt, this paragraph does not form part of the public licenses.

Creative Commons may be contacted at creativecommons.org.