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Toxicology and Applied Pharmacology, 247(2), 8390

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Common adverse effects of GLP-1 receptor agonists include: Gastrointestinal symptoms (nausea, vomiting, diarrhoea, constipation) Injection site reactions Headache Fatigue Dizziness Important safety considerations include: Risk of hypoglycaemia when used with insulin or sulfonylureas (dose reduction of these agents may be needed) Potential worsening of diabetic retinopathy with semaglutide in patients with pre-existing retinopathy [18] Risk of dehydration and acute kidney injury from persistent vomiting or diarrhoea Pancreatitis, gallbladder disease, and potential thyroid C-cell tumours (observed in rodent studies, though human relevance remains uncertain) [19] [20] Patients should be counselled about persistent severe abdominal pain as a potential warning sign of pancreatitis requiring immediate medical attention

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[6] In summary, aside from hypersensitivity, the use of pyridoxine should be guided by clinical necessity, and caution exercised in populations vulnerable to potential risks of excipients or overdose