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Do not use Wegovy, Ozempic, Zepbound, or Compounded Liraglutide + B12 if you are currently pregnant, breastfeeding, or plan to become pregnant or breastfeed

Rybelsus may be the better option for patients who: Have BMI greater than 30 and need significant weight loss support Have A1C greater than 9% requiring aggressive glycemic control Are injection-averse but want GLP-1 benefits Are at high risk for heart problems, regardless of existing diagnosis Do not have gastroparesis or history of medullary thyroid cancer Jardiance may be recommended for patients who: Have established cardiovascular disease or heart failure Have chronic kidney disease (eGFR 30-90 mL/min/1.73m) Are cost-sensitive and need a more affordable option Prefer flexible dosing without strict meal timing Do not have recurrent urinary tract infections or hypotension Combination therapy may be appropriate for patients with A1C greater than 10% despite metformin therapy, or those who would benefit from both cardiovascular protection and weight loss

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