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Recommended timing strategies: Option 1 (Morning dosing for both): Take Rybelsus immediately upon waking with up to 120ml water Wait 30 minutes Take levothyroxine with a full glass of water Wait another 30 minutes before eating breakfast or drinking coffee Total fasting time: approximately 60 minutes from waking Option 2 (Split dosing): Take Rybelsus first thing in the morning as directed Wait 30 minutes, then eat breakfast Take levothyroxine at bedtime (34 hours after last meal) The split-dosing approach may offer better adherence for some patients and ensures maximum separation between the two medications

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doi:10.1139/H08-00 Ashtary-Larky D, Ghanavati M, Lamuchi-Deli N, et al

At week eight, 36 percent (study 1) and 45 percent (study 2) of the treatment group had achieved the primary efficacy outcome, compared to seven percent and 13 percent on vehicle