The decision to initiate pharmacotherapy should involve shared decision-making, considering individual patient values, preferences, treatment goals, and cost considerations, as these medications can be expensive and may face insurance coverage limitations
The pharmaceutical pen formulations of semaglutide and tirzepatide have slightly different guidelines because they use different preservative systems, but the underlying peptide stability is comparable
Multi-dose vials increase risk because, unlike the single-dose auto-injectors used for Mounjaro and Zepbound, they require patients to measure and draw their own doses, a process prone to error without proper training
It also improves: weight loss, follicle maturation, menstrual regularity, and reduces excess facial and body hair
The entire process takes about 30-60 minutes
While lactate alone is not inherently a marker of BD pathology, its elevation in BD may reflect underlying metabolic reprogramming, including altered mitochondrial impairment