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In some countries, reimbursement and costs associated with polypharmacy will likely be a challenge related to GLP-1RA plus SGLT2i combination therapy

Start with the recommended dosage, stay hydrated, and adjust as needed

Shipping should be on cold packs or dry ice with documented chain-of-custody temperature, because lyophilized peptides tolerate brief excursions to ambient but should not be exposed to prolonged warmth

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Patients should be counseled to report concerning symptoms such as neck swelling, difficulty swallowing, persistent hoarseness (potential thyroid issues), or severe abdominal pain, persistent vomiting, or right upper quadrant pain (potential pancreatitis or gallbladder issues)