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Dosing is titrated gradually over weeks to minimize side effects like nausea, and the pace of titration matters significantly for both tolerability and results

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Contraindications Semaglutide methylcobalamin ODT should not be used by individuals with: Personal or family history of medullary thyroid carcinoma (MTC) Multiple endocrine neoplasia syndrome type 2 (MEN 2) Known hypersensitivity to semaglutide or any formulation component History of severe pancreatitis Severe gastrointestinal disease that may be worsened by delayed gastric emptying Severe renal impairment Pregnancy or planned pregnancy The methylcobalamin component has no meaningful contraindications at the doses used