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.
Dosing
Page 9 of 31 of this archive, newest first.
The incidence tables, read line by line
Almost every figure in circulation about tolerability comes from six publications. This is what they say.
What the new Sweden guidance says about stopping
The evidence base is thin and the document says so, which is to its credit.
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.
Australia pharmacy body issues counselling standards for tirzepatide initiation
The evidence base is thin and the document says so, which is to its credit.
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…
How a correct calculation becomes a wrong dose
A pharmacist catches most of these in licensed practice. In this market there is no pharmacist, so the checks have to be structural.
Why the fifth week of a semaglutide dose feels different from the first
An accumulation model, drawn from published parameters, with its assumptions stated.
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.
Why receptor selectivity is the least discussed number in incretin pharmacology
The class is described as though every molecule in it did the same thing. At the receptor, they demonstrably do not.
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.
What the new Australia guidance says about stopping
The evidence base is thin and the document says so, which is to its credit.
Choosing a needle for a subcutaneous peptide
A 4 mm needle at ninety degrees without a skin pinch is adequate for essentially all adults. The persistence of 12.7 mm needles in this market is habit, not reasoning.
Attribution is the hard part
Rapid weight loss by any means raises gallstone risk. Separating that from a direct drug effect requires a comparator, and the trials have one.
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.
The lowest effective dose is a real concept with almost no data behind it
Dose reduction is not withdrawal, and the trials that tested withdrawal cannot be read as testing it.
Diminishing returns, quantified
Where the curve flattens, what flattens with it, and what does not.