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Possibly some mild nausea, though sublingual formulations tend to produce less GI disturbance at initiation than injections because the daily dose is smaller and the peak concentration is lower

Fat absorption changes

References Clinical Pharmacology powered by Elsevier (ClinicalKey) Tirzepatide Monograph

Psychiatry 89 , 10881100 (2018)

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Having medical support during the adjustment period makes the first month easier and sets you up for success as you continue treatment and see the more significant results that typically come in months two, three, and beyond.