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Gradual weight reduction allows hormonal systems to adapt, while rapid loss triggers more pronounced menstrual disruptions

If side effects are troublesome, the SmPC advises that dose escalation may be delayed by an additional week

Metformin treatment study After visit 2, standard-release metformin was titrated as follows: 500 mg daily for 1 week, 500 mg twice daily for 1 week and then 1000 mg twice daily for the remainder of the 3 month study

While this effect can aid in managing diabetes and promoting weight loss, it can also result in adverse complications in some patients

There is an urgent need for clear clinical guidelines and further research to ensure maternal-fetal safety in this growing patient population