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Patients should be advised to: Start with the lowest dose and increase slowly Eat smaller, more frequent meals Avoid high-fat foods Stay well-hydrated Safety monitoring should include vigilance for: Pancreatitis symptoms (severe persistent abdominal pain) discontinue immediately if suspected Gallbladder disease increased risk with rapid weight loss Hypoglycaemia particularly when combined with insulin or sulphonylureas Renal function deterioration especially with dehydration from gastrointestinal effects Diabetic retinopathy monitor in patients with pre-existing retinopathy, particularly with semaglutide Suspected adverse reactions should be reported via the MHRA Yellow Card scheme

Mas recientemente los inhibidores del cotransportador sodio-glucosa tipo 2 han demostrado ofrecer proteccin cardiovascular y renal, pero el riesgo residual sigue siendo alto y su eficacia antihiperglucemiante es limitada en ERC moderada-severa

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