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It should be used cautiously or avoided in patients with a history of pancreatitis, severe gastrointestinal disease (e.g., gastroparesis), or gallbladder disease

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Surgery to solve stomach paralysis: Some patients may need a surgery, or multiple surgeries, to manage their gastroparesis

Extended injection time: At higher volumes, take even longer to inject, 15 to 20 seconds rather than 10

In SURMOUNT-1 (NEJM 2022, 2,539 adults with obesity), the 15 mg arm averaged 22.5% body weight loss at 72 weeks, the 10 mg arm 21.4%, and the 5 mg arm 16.0%

If it takes 5-10 minutes of gentle rolling to achieve a clear solution, that is normal for a lipid-modified peptide