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Its a breakthrough, allowing patients to get something really more effective or get more help to get started, but unfortunately, it has been abused and misused, said Dr

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Relative contraindications requiring careful consideration and enhanced medical supervision include history of pancreatitis, severe gastrointestinal disease including gastroparesis, diabetic retinopathy (requires ophthalmologic monitoring during therapy), severe kidney disease, history of suicidal ideation or severe depression, gallbladder disease or history of cholecystitis, and age under 18 years

The starting dose and escalation schedule remain identical whether you are on metformin or not