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Serious adverse events & deaths (trial reports) One of the most important safety considerations in any clinical programme is the potential for serious adverse events (SAEs) and, ultimately, any deaths that occur during treatment

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counsel on vomiting-related missed doses | | Levothyroxine | Cmax reduced ~16% | Recheck TSH at 6 to 8 weeks | | Digoxin | Tmax delayed 2.5 hours, Cmax reduced 17% | Check trough level at 5 to 7 days | | Metformin | Cmax reduced 9%, AUC unchanged | No adjustment | | Statins | Cmax reduced up to 38%, AUC unchanged | No adjustment | | ACE inhibitors/ARBs | Cmax reduced ~15%, AUC unchanged | No adjustment | | DPP-4 inhibitors | Pharmacologic redundancy | Discontinue DPP-4i | | SGLT2 inhibitors | Additive efficacy, no PK interaction | No adjustment | | DOACs | No data

While it is recommended that women discontinue GLP-1s before pregnancy, the drugs increasingly widespread use means that inadvertent exposure during the first trimester is becoming more common

adults and 8% of Canadian adults reported currently taking a prescription GLP-1