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These drugs have been expensive (often over US$1,000 per month for brand-name products in the US)

Consistency matters more than optimal timing

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However, there may be exceptional circumstances where dose escalation is delayed, such as: Significant gastrointestinal side effects that have not resolved after one month Concurrent acute illness or hospitalisation Patient preference to extend the titration period under medical supervision Concerns about tolerability in frail or elderly patients Healthcare professionals should review patients after starting Rybelsus to assess tolerability, reinforce dosing instructions, and plan dose escalation

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