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Your insurer wants a formulary check, ICD-10 diagnosis (E66.9 or E11.9), documented step-therapy failures, and a letter of medical necessity

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However, severe or persistent stomach pain, vomiting, inability to keep food or liquids down for more than a few hours, or signs of dehydration (dark urine, excessive thirst, dizziness) require immediate medical attention

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The mechanism differs from typical anticholinergic drugssemaglutide doesn't block acetylcholine directly, but its GLP-1 signaling alters the balance between sympathetic and parasympathetic nervous system activity