Individuals at greater risk of low blood sugar whilst taking retatrutide include: Those concurrently prescribed sulphonylureas (e.g., gliclazide, glibenclamide), which stimulate insulin release independently of blood glucose levels dose reduction is often required when initiating potent incretin-based therapies [16] [8] Patients using insulin therapy , where doses may need to be reduced as glycaemic control improves or caloric intake falls People with renal impairment , who may have a generally increased risk of hypoglycaemia, particularly if also taking insulin or sulphonylureas (note: the specific effect of renal impairment on retatrutide clearance has not yet been established, as no SmPC exists) Individuals who are fasting , following a very low-calorie diet, or who have significantly reduced their food intake a common occurrence given retatrutide's appetite-suppressing effects Those with a history of hypoglycaemia or hypoglycaemia unawareness Older adults, who may have reduced counter-regulatory responses to falling blood glucose The appetite suppression associated with retatrutide can lead to substantially reduced caloric intake, which whilst beneficial for weight loss may necessitate a review and reduction of concomitant glucose-lowering therapies

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