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Dosages might need adjustment to stay effective

Trials have demonstrated significant reductions in major adverse cardiovascular events, systolic blood pressure, and triglyceride levels

These medications include semaglutide (Ozempic, Wegovy), liraglutide (Victoza, Saxenda), and dulaglutide (Trulicity)

Two structural modifications distinguish this analog from the parent tridecapeptide: substitution of Met-4 with norleucine (Nle) and inversion of Phe-7 to the D-enantiomer, both of which are widely documented in the peptide chemistry literature as means of increasing conformational and oxidative stability of the reference standard

Data on File CSR 12404

We suppose the change is because the initial doses are enough to keep B12 levels within the desired range