doi: 10.7326/0003-4819-137-12-200212170-00007
To manage this: Eat smaller but more frequent meals
Possible adverse effects may include: Injection site reactions : Redness, swelling, irritation, or discomfort Gastrointestinal symptoms : Nausea, vomiting, stomach cramps, or diarrhea Headaches or dizziness Allergic reactions : Rash, itching, shortness of breath, or facial swelling (rare) Increased heart rate or anxiety (typically temporary from B-vitamins) Fatigue or weakness if used improperly Elevated liver enzymes when taken in excess particularly with methionine or choline Insomnia if taken late in the day due to increased energy levels Who should avoid or use caution
[30] On April 21, 2026 , CMS declined to implement it in Part D for 2027 and extended the temporary GLP-1 Bridge through Dec 31, 2027 instead
It is not a replacement for metformin for people who have been prescribed it
With this in mind, the doses of Botox used medically are much lower than those that cause botulism
