oasis 1 oral semaglutide 50 mg nejm 2023 obesity Low Dose for Overweight Adults (OASIS-4) | 50 mg of oral #semaglutide
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If you're still in titration (increasing doses weekly or bi-weekly), you haven't yet reached the dose needed for full effect

monitoring may be required Polycythemia vera: Correcting B12 deficiency may unmask underlying polycythemia Masking folate deficiency: B12 supplementation can mask the hematologic signs of folate deficiency while allowing neurological damage to progress Allergic reactions: Rare hypersensitivity reactions have been reported, including anaphylactic shock with cyanocobalamin Common Side Effects Mild diarrhea Injection site reactions: pain, swelling, itching Feeling of generalized body swelling Mild headache Temporary reddish urine (normal B12 is water-soluble and excreted) Seek Medical Attention For Signs of serious allergic reaction: rash, hives, facial swelling, difficulty breathing Chest pain or irregular heartbeat Signs of low potassium: muscle cramps, weakness, irregular heartbeat Vision changes (especially if you have Lebers disease) Drug Interactions Chloramphenicol: May antagonize the hematopoietic response to B12 Metformin, proton pump inhibitors, H2 blockers: Can reduce B12 absorption (these are reasons to use injectable B12 instead of oral) Nitrous oxide: Can inactivate B12 in the body Use in Pregnancy and Breastfeeding B12 is generally considered safe during pregnancy and breastfeeding when used at appropriate doses
(aad.org) For textural change, Microneedling may be a useful collagen-remodeling option once the breakout cycle is quiet
