This approach is clinically defensible and reduces barriers to starting treatment, but it means that some patients may begin treatment without the metabolic baseline data that could improve their care
The empty B12 vial can also go into the sharps bin
uninterrupted sitting (adults with and without T2D
Dose adjustment strategies: If symptoms are intolerable despite supportive measures, your prescriber may recommend: Slowing the titration schedule (extending time at each dose level) Temporarily reducing to the previous tolerated dose Maintaining the once-weekly injection schedule (timing within the day has limited evidence for efficacy) When to seek medical review: Symptoms persisting beyond 46 weeks at stable dose Inability to maintain adequate nutrition or hydration Weight loss exceeding expected therapeutic effect New or severe abdominal pain Signs of pancreatitis (severe upper abdominal pain radiating to back) Symptoms of gallbladder disease (right upper quadrant pain, jaundice) Patient safety advice : Discuss any dose changes or stopping with your prescriber

If youre experiencing any of the following, contact your provider: Youve missed multiple periods in a row Youre experiencing changes to your bleeding, including heavier, lighter, or more painful periods Youre spotting between periods You have a history of PMOS/PCOS, endometriosis, fibroids, or fertility issues You recently started a new medication or birth control method, such as an IUD (intrauterine device) You think you might be pregnant Youre postmenopausal and experience new bleeding You have questions or concerns about the changes youre experiencing Important Note Seek urgent care for very heavy bleeding, severe pelvic pain, fainting, chest pain, shortness of breath, or symptoms that feel severe or unusual