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Silva YP, Bernardi A, Frozza RL

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10.1073/pnas.1421285111 Proc

Other significant considerations include: Injection site reactions (for subcutaneous formulations) Hypoglycaemia risk (particularly if used alongside other glucose-lowering medications) Pancreatitis (rare but serious) Gallbladder disease (including gallstones and cholecystitis) Dehydration leading to acute kidney injury (particularly with severe gastrointestinal side effects) Diabetic retinopathy complications (particularly noted with semaglutide in diabetes patients) Potential thyroid effects (medullary thyroid carcinoma risk in animal studies, though human relevance remains unclear) A Parkinson's-specific concern is that GLP-1 receptor agonists delay gastric emptying, which may further impair levodopa absorption and potentially worsen motor fluctuations or 'OFF' periods in patients on this medication

Difficulties consist of erratic absorption, skin irritation from topical formulations, and no definitive timing recommendation with respect to ovulation or ART