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Lyophilized: Hold at 20 C (4 F) or colder for long-term keeping

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That said, there are biologically plausible indirect pathways by which semaglutide treatmentespecially when accompanied by rapid appetite suppression, gastrointestinal adverse effects, and clinically meaningful weight losscould unmask or exacerbate pre-existing vaginal symptoms (for example, genitourinary syndrome of menopause) or contribute to discomfort through dehydration, altered sex steroid milieu, or pelvic soft-tissue volume changes

10.1208/s12249-009-9264-8 [DOI] [PMC free article] [PubMed] [Google Scholar] Yadav A

Vomiting occurs less frequently than nausea but can be problematic when it does occur, particularly if it leads to dehydration or interferes with nutrition and medication absorption

Semaglutide works by slowing stomach emptying and reducing appetite, which can increase dehydration risk if fluid intake drops