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Less frequent complications carry more weight, including pancreatitis, gallstone formation during rapid weight reduction, and severely delayed gastric emptying that can persist after the medication is stopped

The BMJ also reported that the situation was made possible after Novo Nordisk did not pay a C$250 annual maintenance fee, a decision that ended Canadian patent protection earlier than in most other markets

The weight loss is also more aggressive, which raises the muscle loss concern more acutely

In the SURPASS clinical trials, 12% to 22% of participants on tirzepatide reported diarrhea

Disadvantages: requires supplies and technique, room for calculation errors, 28-day window after mixing

Discuss the risks and potential alternatives with your healthcare provider