46 Based on a lack of robust data regarding the safety and efficacy of simultaneous use of DPP-4 inhibitors and GLP-1 agonists, the combination is not recommended
Out-of-pocket cash pay at the pharmacy counter without any program still runs $900$1,200/month
That includes: People with severe kidney disease People who are pregnant or planning to become pregnant People aged 65 and older with a history of certain conditions, such as heart disease, liver disease, coma, or diabetic ketoacidosis People who consume high amounts of alcohol each week, which constitutes 8 or more drinks for individuals assigned female at birth (typically, women) and 15 or more drinks for individuals assigned male at birth (typically men) Lastly, some medications can interact with metformin and increase your risk for severe side effects
If hematocrit rises above 54%, discuss therapeutic phlebotomy or TRT dose adjustment with your provider
Reduced Appetite
Daily administration would produce accumulating plasma levels far beyond the studied range, dramatically increasing side effects without proportional benefit