Alternative medication classes should be considered if GLP-1 therapy proves intolerable: SGLT2 inhibitors (such as dapagliflozin, empagliflozin) for type 2 diabetes, which work via a completely different mechanism and rarely cause gastrointestinal side effects DPP-4 inhibitors (such as sitagliptin, linagliptin), which enhance endogenous GLP-1 activity more gently Metformin remains first-line for type 2 diabetes, though it can also cause gastrointestinal side effects Orlistat for weight management, though this also has gastrointestinal side effects of a different nature For weight management specifically, NICE recommends a comprehensive approach including dietary modification, increased physical activity, and behavioural interventions, with or without pharmacotherapy
Coenzyme Q10 supplementation for prophylaxis in adult patients with migraine-a meta-analysis
Hachicha M, Naccache PH, McColl SR: Inflammatory microcrystals differentially regulate the secretion of macrophage inflammatory protein 1 and interleukin 8 by human neutrophils: a possible mechanism of neutrophil recruitment to sites of inflammation in synovitis
However, they also recognized that semaglutide was not a magic weight-loss potion, but could be a practical addition to their practices holistic medical weight-loss program