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Purity reported by HPLC
The revelation came from Jill Furman, director of CDERs Office of Compliance, during the 2025 Enforcement, Litigation, and Compliance Conference, where she addressed enforcement trends and compliance priorities
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The reason for this is that the initial wave of drug-induced hepatocellular destruction is followed by a robust innate immune response, in which invading inflammatory cells release toxic oxidants and cause a second wave of destruction
A 2023 case series in Annals of Pharmacotherapy described INR instability in three patients within 6 to 10 weeks of starting semaglutide, requiring warfarin dose adjustments [6]
Instead of advancing from 1.0 mg to 1.7 mg at week 9 as the standard protocol specifies, your provider may extend the 1.0 mg phase for an additional 4 to 8 weeks until GI symptoms stabilize
