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However: Patients with BMI over 45 Severe sleep apnea Advanced type 2 diabetes Longstanding obesity may achieve more durable remission through bariatric surgery

If the package feels warm or has been in transit for extended periods without adequate cooling, patients should contact their pharmacy to verify whether the medication remains safe to use

These effects are typically minor enough that many people wonder whether the medication is working at all

But others may need chronic medication. Study Limitations to Consider The trials did not follow the patients beyond a year of maintenance dosing, making it difficult to know what would happen longer term