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Insurance companies typically do not cover OFF LABEL prescribing of FDA approved for type 2 diabetes for weight loss without a type 2 diabetes diagnosis

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Chiang PH, Chang TY, Chen JD

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Soliqua 100/33 (active ingredients: insulin glargine and lixisenatide) Initial FDA Approval: 2016 Side Effect Update Date: November 1, 2024 Medication Description: Treats type 2 diabetes Updated GLP-1 Drugs Side Effects/Safety Information: Warns about the serious risk of pulmonary aspiration during general anesthesia or deep sedation

Key monitoring parameters include: Weight and BMI : Track weight loss progress and ensure changes are gradual and sustainable (typically 0.51 kg per week) Mental health status : Assess mood, anxiety levels, and any emergence of suicidal ideation, particularly in the first weeks of therapy Gastrointestinal symptoms : Evaluate tolerance and implement management strategies for nausea, vomiting, or constipation Blood pressure and heart rate : Both medications can affect cardiovascular parameters Blood glucose levels : Essential in patients with diabetes or prediabetes Vision changes : Monitor for blurred vision or visual disturbances, particularly in patients with diabetes who may need retinal screening Gallbladder symptoms : Be alert for right upper quadrant pain that could indicate gallstones Common side effects patients should be aware of include: From Wegovy: nausea (most common), diarrhoea, constipation, abdominal pain, headache, fatigue, and injection site reactions From Wellbutrin: insomnia, dry mouth, headache, nausea, dizziness, and increased sweating Red flag symptoms requiring urgent medical attention include: Severe, persistent abdominal pain (possible pancreatitis) Persistent vomiting preventing oral intake Visual changes or eye pain Rapid heart rate or chest pain Seizures or loss of consciousness Worsening depression or suicidal thoughts Signs of allergic reaction (rash, swelling, difficulty breathing) Patients should contact their GP promptly if they experience concerning symptoms and should never discontinue either medication abruptly without medical guidance, as this could lead to withdrawal effects or worsening of underlying conditions