All patients: Ask your prescriber about therapeutic alternatives
The Reconstitution Math: Making Sense of the Numbers Now, we get to the core of the matter
One older study on Byetta (exenatide) showed minimal transfer, but there are no studies on semaglutide, tirzepatide, or liraglutide in breast milk, and no data on infant outcomes when exposed via breast milk
My general framework: Start with semaglutide if cost is a significant concern, or if there is no strong reason to expect poor tolerance Start with tirzepatide if the patient has tried semaglutide before and struggled with side effects, if faster initial response matters clinically, or if the patients goals require larger total weight loss Switch to tirzepatide if a patient on semaglutide is experiencing persistent nausea or has plateaued and escalation options are limited One pattern worth noting: men I see a consistent pattern with male patients who struggle to tolerate semaglutide nausea and GI disruption can be particularly disruptive for them, and theyre often less willing to push through it
RetaLABS Semaglutide 10mg is a lyophilised research vial of the benchmark GLP-1 receptor agonist (the most extensively characterised compound in the GLP-1 class with the longest peer-reviewed publication record)
However, in clinical trials, approximately 4-7% of participants stopped taking semaglutide due to gastrointestinal adverse effects