Medication Interactions and Metabolic Factors Beyond Genetics Even genetically favorable patients may experience semaglutide failure due to drug interactions, thyroid dysfunction, uncontrolled diabetes, or polycystic ovary syndrome

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The increased risk was seen even after accounting for reflux disease, which is already known to be more common on GLP 1 drugs
Hypoglycemia risk is higher when tirzepatide is used with insulin or sulfonylureas, which may require dose adjustments of these medications