Nausea, mild diarrhoea or constipation, and fatigue are the most common, particularly in the first few weeks while the dose is escalating. Most settle within 4–6 weeks. We titrate slowly to minimise impact — that’s a big part of the monthly review.
These medications are not appropriate for everyone. Pregnancy, breastfeeding, personal or family history of medullary thyroid cancer, multiple endocrine neoplasia syndrome type 2 (MEN-2), severe gastroparesis, and certain pancreatic conditions are full contraindications. Several other conditions require caution. Your pharmacist works through this in detail at your consultation.
Both medications are designed to be titrated upward over several months. We escalate at the speed your body can handle, not on a fixed schedule. Most patients reach a stable maintenance dose within 3–5 months.
Most patients stay on treatment for 12–24 months. Abrupt stopping is associated with weight regain, so we talk through a step-down plan together when you’re close to your goal. The monthly review is where this decision happens — it isn’t a fixed protocol.
Both medications are real clinical interventions with real side effects and dose decisions that change every few weeks. Monthly in-person review lets your pharmacist check your weight, blood pressure, side-effect profile and overall wellbeing — and adjust the plan in real time.
NHS access is currently limited and gated by tier-3 specialist clinics with very long waits. Private prescription via face-to-face pharmacist consultation gives same-day decisions after your initial 40-minute consult. Cost is your medication plus the consultation only — no extra subscription.