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Semaglutide may also be selected because of a patients medical needs, previous response, insurance coverage, medication access, or tolerability

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The anti-itch combination protocol: Layer 1: Oral antihistamine (cetirizine 10mg in the morning) Layer 2: Topical hydrocortisone 1% applied to affected area twice daily Layer 3: Cold compress for breakthrough itch (10 minutes as needed) Layer 4: Diphenhydramine 25mg at bedtime if itch disrupts sleep Avoid scratching at all costs