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These situations warrant individual evaluation rather than automatic exclusion

For oral semaglutide (Rybelsus), the FDA prescribing information specifically notes increased thyroxine exposure when co-administered with levothyroxine

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Switching injection sites, adjusting injection timing relative to meals, or adding anti-nausea medication during the adjustment period are all standard interventions with clinical support

A thorough history, physical examination, and appropriate investigationswhich may include blood tests, FIT, or endoscopic proceduresare essential to establish the underlying cause and ensure patient safety

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