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After starting and after each dose increase, tirzepatide can cut the peak absorption of an oral contraceptive by more than half, so the label guidance is a non-oral method or added barrier protection for four weeks after starting and four weeks after each increase. It is a first-dose-and-escalation effect, not a permanent block on all oral drugs
Enlarged spleen: thalassemia can cause the spleen to enlarge as it tries to filter out abnormal red blood cells
Yet, a deficiency exists in as many as 43% of older adults (4)
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