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Third European evidence-based consensus on diagnosis and management of ulcerative colitis

Red flag symptoms requiring urgent assessment: Severe, persistent vomiting Inability to tolerate oral intake for more than 24 hours, suggesting possible gastroparesis or other complications Signs of dehydration Decreased urine output, dizziness, dry mucous membranes, or tachycardia Severe abdominal pain Particularly if acute, localized, or associated with fever, which may indicate pancreatitis or other acute abdominal pathology Right upper quadrant pain, fever, or jaundice Suggesting possible gallbladder disease Severe abdominal distension with inability to pass stool or gas Potential bowel obstruction or ileus Hematemesis or melena Suggesting gastrointestinal bleeding Progressive dysphagia Difficulty swallowing that worsens over time Situations requiring routine consultation: Patients should contact their healthcare provider for non-urgent evaluation when experiencing persistent nausea or vomiting lasting beyond 2-3 weeks at a stable dose, as this may indicate inadequate adaptation or the need for dose adjustment

Do not double dose to make up for a missed injection

In animal experiments involving shrews (which are able to vomit), GLP-1RAs elicit frequent episodes of vomiting, while GIPRAs do not

Everything else this article has covered gives you the context to use it well

Dulaglutide and liraglutide are older GLP-1 agents with less robust weight loss efficacy than newer compounds