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It also notes age eligibility varies by state, with most requiring 18 or older and some restricting to 21 or older, and that some states authorize semaglutide first while requiring step therapy before tirzepatide is approved

Available Strength Side Effects Nausea or vomiting Diarrhea Abdominal pain Headache Fatigue Dizziness Decreased appetite Constipation Interactions Other GLP-1 agonists Medications affecting gastric emptying Insulin Certain antibiotics Oral diabetes drugs (may require adjustments) Warfarin Precautions and Warnings Not to be used in patients with severe renal failure, a history of pancreatitis, or thyroid cancer

Sies H, Belousov VV, Chandel NS, Davies MJ, Jones DP, Mann GE, Murphy MP, Yamamoto M, Winterbourn C

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Decreasedin Vivo Oxidative Stress and Decreased Platelet Activation Following Metformin Treatment in Newly Diagnosed Type 2 Diabetic Subjects