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Use either Formulation R1 or Formulation R2

Seeing the same clinician face-to-face matters, especially for a medication class where dose titration and GI side effects are common enough that the STEP-1 trial (Wilding et al., NEJM 2021) reported GI adverse events in 74.2% of the semaglutide group

A thorough clinical assessment may include: Cardiovascular examination to assess peripheral pulses and circulation Blood tests including full blood count (to exclude anaemia), thyroid function tests, and assessment of glycaemic control Review of concurrent medications that might affect circulation Assessment of hydration status and nutritional adequacy NICE guidance emphasises the importance of regular monitoring during GLP-1 receptor agonist therapy, and any new or persistent symptoms should be discussed during routine follow-up appointments or sooner if concerning

While some flexibility is allowed, consistency is always the key