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Short non-diabetic data support remaining at 2.5 mg when weight and insulin-resistance markers are already moving and tolerability favors a hold. The label still positions 2.5 mg as the starter before 5 mg, so it is a defensible low-dose floor for selected users rather than a replacement for the 5 mg obesity-trial floor

Those with pre-existing cardiac conditions or on medications affecting potassium levels may require closer monitoring

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That includes: Pernicious anemia

Who should avoid this treatment