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Vomiting, severe abdominal pain, or signs of pancreatitis (upper left abdominal pain, back pain, or elevated pancreatic enzymes) require immediate medical attention and warrant pausing further dose increases

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They are prepared by state-licensed compounding pharmacies under Section 503A of the Federal Food, Drug, and Cosmetic Act, which allows compounding of medications in shortage or when a prescriber determines a patient-specific need

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Notably, patients with a BMI 35 kg/m 2 experienced greater benefits than those with lower BMI, potentially underscoring the benefit derived from targeting obesity-related metabolic drivers of heart failure rather than modulation of myocardial loading or neurohormonal mediation [118, 121]