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Consider: Baseline blood pressure and heart rate measurement before starting combination therapy Regular monitoring during dose titration of either medication Prompt evaluation of palpitations, chest pain, or shortness of breath Caution in patients with pre-existing cardiovascular disease , including coronary artery disease, arrhythmias, or uncontrolled hypertension ECG evaluation if indicated by clinical history or symptoms Nutritional adequacy must be maintained

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Eating balanced meals with adequate protein, fiber, and healthy fats at each sitting helps stabilize blood sugar naturally and reduce these fluctuations

For medium-term storage ranging from one to three years, refrigeration at two to eight degrees Celsius provides an excellent balance between accessibility and stability

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