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GUIDED DUAL PATHWAY PROTOCOL Your clinician builds your tirzepatide protocol around your labs, your response, and your goals

Contraindications: Patients who have a personal or family history of medullary thyroid carcinoma (MTC), multiple endocrine neoplasia syndrome type 2 (MEN 2), or those allergic to the active ingredient or any of the excipients of the drug should not use it

These include: [3] Nausea Vomiting Constipation Stomach or abdominal pain Loss of appetite Dry mouth Headache Nervousness Dizziness Trouble sleeping Sweating Weight loss Irritability Restlessness More serious side effects are: Blurred vision Irregular or fast heartbeat Mood or behavioral changes, like depression, hallucinations, or suicidal thoughts or behaviors Muscle twitching or shaking Signs of blood flow problems, like cold toes or numbness Change in sexual interest or ability Swollen ankles or feet Extreme fatigue Rapid or unexplained weight loss People with certain co-occurring conditions may not be able to take Vyvanse

The neuropeptide calcitonin gene-related peptide stimulates insulin-like growth factor I production by primary fetal rat osteoblasts