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In addition to an FDA warning letter, another main concern is pharmacy transparency

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In one case, a patient who used compounded semaglutide tried to measure a dose in units and accidentally took 10 times more than the intended dose

The dose is then titrated upwards (typically by 24 units every 37 days) based on fasting glucose measurements, aiming for individualised target levels, commonly 57 mmol/L upon waking, as recommended by NICE