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Seek urgent medical attention (call 999 or go to A&E) if you experience: Severe or persistent vomiting, or inability to keep fluids down for more than 24 hours Severe upper abdominal pain, particularly if it radiates to the back (possible pancreatitis) Severe right-sided upper abdominal pain, with or without fever or yellowing of the skin or eyes (possible gallbladder problems a recognised class signal with GLP-1 receptor agonists) [14] [15] Contact NHS 111 or your GP if you experience: Fast, irregular heartbeat or palpitations Symptoms of hypoglycaemia (shakiness, sweating, confusion), particularly if taking insulin or other glucose-lowering medicines Dizziness or signs of dehydration (reduced urine output, dry mouth, light-headedness) If you think you have experienced a side effect from any medicine, you can report it via the MHRA Yellow Card Scheme at yellowcard.mhra.gov.uk or through the Yellow Card app

The crucial nuance is the oral pivot: Beyond injectables like tirzepatide, Lillys orforglipronan oral GLP1 in developmentcould be an equally important volume driver

Finally, it is important to highlight the immunomodulatory effects of tirzepatide