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The following principles reflect general best practice for handling lyophilised injectables in such environments

Patients may need a more careful discussion if they have a history of: Previous NAION in one eye Significant optic nerve crowding Diabetes with vascular complications Sleep apnea, especially untreated sleep apnea High blood pressure or low nighttime blood pressure Cardiovascular disease Sudden unexplained vision loss in the past This does not automatically mean a GLP-1 medication is unsafe, but it does mean the patient should have a personalized risk-benefit discussion with their medical provider

Never add water to a still-frozen peptide

Another theory is that semaglutide may alter the reward system in the brain that is involved in food cravings and addiction

Godoy, L., Fernandini, R., & Johnson, A

Floros, K