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if you have diabetes and take insulin or sulfonylureas, monitor for hypoglycaemia and discuss potential dose adjustments with your healthcare provider Hyponatraemia : SSRIs like escitalopram have been associated with low sodium levels, particularly in older adults or those taking diuretics Gallbladder disease : Semaglutide is associated with increased risk of gallstones and cholecystitis Kidney function : Severe vomiting or diarrhoea from Wegovy can lead to dehydration and acute kidney injury Diabetic retinopathy : For people with diabetes and pre-existing diabetic retinopathy, semaglutide requires ophthalmic monitoring Rare but serious effects requiring immediate medical attention include: Signs of pancreatitis (severe abdominal pain radiating to the back) Symptoms of serotonin syndrome (agitation, confusion, rapid heart rate, muscle rigidity) Severe allergic reactions Persistent vomiting leading to dehydration Maintaining a symptom diary can help you and your healthcare provider identify patterns and adjust treatment as needed

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Exendin-4 significantly inhibits different cell lines and induces apoptosis through the mechanism modification of apoptosis-related genes, which plays a role in extrinsic pathways and cell survival genes [78]

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warfarin antagonises vitamin K availability and a stable intake is required