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Baseline glycemic control : Patients with higher HbA1c levels may require more aggressive dose escalation, though this must be balanced against tolerability

Decision factors: Weight loss goals: Want maximum weight loss and can tolerate side effects: Tirzepatide (Zepbound) shows ~4% greater weight loss than semaglutide on average Want proven cardiovascular benefits: Semaglutide has demonstrated 20% reduction in major cardiovascular events in the SELECT trial Want to try oral option: Oral semaglutide (Rybelsus) for diabetes, though weight loss is less than injectable Side effect sensitivity: Some people tolerate one better than the other

These symptoms typically fade by the end of the second week at this dose

Additionally, semaglutide slows gastric emptying, which theoretically could affect the absorption timing of oral medications, though this has not been shown to significantly impact antibiotic effectiveness in clinical practice