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Lancet 366 , 985990 (2005)

Clinical practice recommendation on periprocedural use of GLP-1/GIP receptor agonists

Metabolism The primary route of elimination for semaglutide is metabolism following proteolytic cleavage of the peptide backbone and sequential beta-oxidation of the fatty acid sidechain

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A three week flat line at a dose you have been holding is a real signal that it might be time to consider the next step