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Important safety warning seek urgent medical attention if you experience any of the following: Severe or persistent abdominal pain (which may indicate acute pancreatitis) Right upper quadrant pain, fever, or jaundice (which may indicate gallbladder disease) Reduced urine output, dizziness, or signs of dehydration (which may indicate acute kidney injury) Severe nausea or vomiting preventing adequate fluid intake Signs of a serious allergic reaction (swelling, difficulty breathing, rash) Symptoms of hypoglycaemia such as dizziness, sweating, or confusion These may represent serious adverse effects requiring prompt clinical assessment

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Substituting another GLP-1 receptor agonist requires clinical review because dose schedules and tolerability are not identical

The trans-sulphuration pathway involves conversion of homocysteine to cystathione and ultimately to cysteine in two vitamin B6 dependent reactions catalysed by cystathione--synthase and cystathione lyase respectively (Figure 2)