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Personal or family history of MTC or Multiple Endocrine Neoplasia syndrome type 2 (MEN2) is a direct contraindication

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You'll need prior authorization, which typically requires BMI 30 (or 27 with comorbidities), 6 months of documented lifestyle efforts, and possibly step therapy

The tirzepatide has substantially cleared, but the semaglutide has not yet reached full steady-state concentration

Mayo Clinic describes how semaglutide reduces appetite and supports weight management when paired with diet and activity