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Stacked on top of insulin or a sulfonylurea it can, and the lever is de-intensifying that background drug, not lowering the tirzepatide dose. Over-loss in low-BMI deep responders Across the obesity trials, about 7% of participants fell below a BMI of 22, some by week 12

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These are more considerations of medications affecting vitamin status (rather than the vitamin affecting the medication), but they illustrate the clinical judgment required when co-administering this injection with certain treatments

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