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Important safety considerations include a boxed warning for risk of thyroid C-cell tumors (contraindicated in patients with personal/family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2), and risks of pancreatitis, gallbladder disease, acute kidney injury with dehydration, and diabetic retinopathy complications with semaglutide

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Metformin also enhances endothelial function, improves lipid metabolism, reduces the intima-media thickness of the carotid artery, and lowers the risk of cardiovascular diseases such as hypertension ( 3.2.3 Impact of metformin on pregnant patients with polycystic ovary syndrome and preeclampsia Research has shown that metformin can inhibit the placental secretion of soluble fms-like tyrosine kinase 1 and promote arterial dilation, which suggests metformin may be a potential preventive and therapeutic agent for preeclampsia

Semaglutide works by slowing stomach emptying and signaling fullness to your brain, which is why consistent weekly dosing produces better results than split doses

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