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4 This is the same vagal circuit that Samsoms pramlintide study implicated: the gastric-emptying delay is a brain-to-stomach command relayed down the vagus, not a peptide throttling the pylorus directly

This is normal and usually temporary

Adverse effects observed in trials to date include: Gastrointestinal symptoms nausea, vomiting, diarrhoea, and constipation (common with GLP-1 receptor agonists) Reduced appetite and weight loss , which may be excessive in some individuals Elevated heart rate , a concern noted with glucagon receptor agonism As with other incretin-based therapies, there is also a class-level signal for acute pancreatitis and gallbladder disease (including cholelithiasis and cholecystitis)

Key safety considerations from the FDA label and clinical experience: (1) Thyroid C-cell tumors: semaglutide causes C-cell hyperplasia in rodents at clinical exposures