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Seek immediate medical attention for: Severe, persistent abdominal pain, especially if different from typical IBS pain or radiating to the back (possible pancreatitis) Persistent vomiting preventing adequate fluid intake Signs of dehydration (decreased urination, dizziness, extreme thirst) Severe constipation lasting more than 3-4 days without bowel movement Blood in stool or black, tarry stools Yellowing of skin/eyes, right upper quadrant pain (possible gallbladder disease) Markedly reduced urination (possible acute kidney injury) Fever accompanying gastrointestinal symptoms Neck mass, difficulty swallowing, persistent hoarseness (thyroid concerns) Allergic reactions (rash, itching, swelling, severe dizziness) Scheduled follow-up should occur within 4-6 weeks of initiating therapy and after each dose escalation

Combination therapy with basal insulin and a GLP-1 receptor agonist can be highly effective, often allowing lower insulin doses

E129 May have a detrimental effect on activity and attention in children.

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