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Immediate medical attention is required if any of the following occur: Severe, persistent abdominal pain, particularly if radiating to the back (possible pancreatitis) Persistent vomiting preventing fluid intake for more than 24 hours Signs of dehydration: dark urine, dizziness, reduced urination, extreme thirst Symptoms of gallbladder disease: right upper abdominal pain, fever, jaundice Allergic reactions: rash, difficulty breathing, facial swelling For people with diabetes: worsening vision or diabetic retinopathy symptoms Symptoms of hypoglycaemia: shakiness, confusion, sweating, rapid heartbeat Pregnancy or suspected pregnancy (Wegovy is contraindicated in pregnancy) Patients should contact their GP or prescriber within a few days if they experience: Intolerable nausea or vomiting that persists beyond the first week of a new dose Severe constipation unresponsive to dietary changes and over-the-counter remedies Persistent diarrhoea lasting more than a few days Unusual or concerning weight loss patterns Mood changes, depression, or suicidal thoughts Thyroid symptoms: persistent hoarseness, lump in the neck, difficulty swallowing Concerns about medication interactions Routine follow-up appointments should be scheduled at regular intervals during re-titration, typically: Before restarting treatment (baseline assessment) After 8-12 weeks (mid-titration review) After reaching maintenance dose Every 3-6 months thereafter for ongoing monitoring These appointments allow monitoring of weight loss progress, assessment of side effects, review of dietary and lifestyle modifications, and evaluation of cardiovascular risk factors

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