The eighteenth month, and the conversation that should have happened in the third
Two withdrawal-design trials tell us what happens when treatment stops. Neither tells us what the lowest effective maintenance dose is.
Patient Notes in 2025
Page 2 of 11 of this archive, newest first.
In-use periods, and the ones nobody can give you
A needle blunts on first use. Reuse is uncomfortable, and it is a documented contributor to lipohypertrophy.
What the new Sweden guidance says about stopping
The evidence base is thin and the document says so, which is to its credit.
Portugal pharmacy body issues counselling standards for exenatide initiation
The evidence base is thin and the document says so, which is to its credit.
Percentage of loss, absolute kilograms, and the sleight of hand between them
What was pre-specified, what was exploratory, and what was calculated afterwards by people who did not run the trial.
Australia pharmacy body issues counselling standards for tirzepatide initiation
The evidence base is thin and the document says so, which is to its credit.
Load, not cardio: the distinction the general advice keeps losing
Mass and function are different endpoints and training affects them differently. Most coverage treats them as one.
What the new Norway guidance says about stopping
The evidence base is thin and the document says so, which is to its credit.
Delayed emptying explains some of this, and not all of it
The receptor populations that produce satiety and the ones that produce nausea overlap substantially. That is why the ceiling of this drug class is where it is, and it is…
Maintenance dosing: what is licensed, what is practised, and what is evidenced
Every withdrawal trial compared full dose against nothing. The clinically interesting comparison — full dose against a reduced one — has not been randomised.
What a low result means when intake has halved
Reduced intake is a plausible mechanism for deficiency. Reduced absorption is not, and the two are conflated in most of the advice.
Switzerland pharmacy body issues counselling standards for dulaglutide initiation
The evidence base is thin and the document says so, which is to its credit.
What the new Ireland guidance says about stopping
The evidence base is thin and the document says so, which is to its credit.
Ireland pharmacy body issues counselling standards for semaglutide initiation
The evidence base is thin and the document says so, which is to its credit.
New Zealand pharmacy body issues counselling standards for semaglutide initiation
The evidence base is thin and the document says so, which is to its credit.
Percentage of loss, absolute kilograms, and the sleight of hand between them
A substudy powered to describe a mean is not a substudy powered to detect a clinically meaningful individual change.
What the new Australia guidance says about stopping
The evidence base is thin and the document says so, which is to its credit.
The United Arab Emirates pharmacy body issues counselling standards for dulaglutide initiation
The evidence base is thin and the document says so, which is to its credit.
Denmark pharmacy body issues counselling standards for liraglutide initiation
The evidence base is thin and the document says so, which is to its credit.
Storage after reconstitution, and the evidence behind the numbers
The air shot before a pen injection removes air from the cartridge and confirms flow. Skipping it can mean a materially reduced dose, and it is skipped constantly.