Monitoring: The pharmacy informatics team created dashboards to track ePA volume by drug category
Online retailers arent monitored by any governing health organization, so theres a high risk that products have been mislabeled or contain impurities
Most often, healthcare professionals prescribe phentermine and topiramate after youve tried other lifestyle modifications for weight loss but havent seen significant results

More serious but less common adverse effects require clinical vigilance: Pancreatitis : Patients should be counselled to stop the medication and seek immediate medical attention if they experience severe, persistent abdominal pain radiating to the back [1] [5] Gallbladder disease : Rapid weight loss associated with GLP-1 therapy may increase cholelithiasis risk [1] Hypoglycaemia : Particularly when used alongside insulin or sulphonylureas in diabetes management Diabetic retinopathy : Semaglutide requires caution in patients with pre-existing retinopathy, who should be monitored regularly [1] Renal impairment : Dehydration from gastrointestinal side effects may affect kidney function Specific considerations for individuals with eating disorders include the potential for GLP-1 medications to exacerbate restrictive eating patterns or mask hunger cues in vulnerable individuals

Tapering Considerations: Gradually reduce GLP-1 dosing while increasing fiber and protein intake Begin nutraceutical support (e.g., berberine, chromium) 24 weeks prior to taper Monitor lean mass and glycemic variability Support appetite signaling with mindful eating and circadian regulation Address gut motility and emotional eating patterns with botanical support Clinical Example: A Case in Practice A 52-year-old female on semaglutide for 6 months presented with nausea, fatigue, and concern about lean mass loss