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Shaking the vial : Denatures the peptide

[DOI] [PubMed] [Google Scholar] 416.Shrestha N, et al

Conditions like gastroparesis, achlorhydria, or chronic acid reflux may reduce oral medication absorption

Semaglutide Wegovy / Ozempic Mechanism: GLP-1 receptor agonist (single target) Weight loss: ~15-17% body weight (STEP trials, 68 weeks) Dosing: Weekly injection, titrated from 0.25mg to 2.4mg Common side effects: Nausea, vomiting, diarrhea, constipation (typically transient) Availability: Longer track record, more widely available Cardiovascular data: SELECT trial demonstrated 20% reduction in major cardiovascular events Tirzepatide Zepbound / Mounjaro Mechanism: Dual GLP-1 + GIP receptor agonist (two targets) Weight loss: ~20-22% body weight (SURMOUNT trials, 72 weeks) Dosing: Weekly injection, titrated from 2.5mg to 15mg Common side effects: Similar GI profile to semaglutide