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This early response reflects the medication's rapid activation of appetite-suppressing pathways in the hypothalamus and brainstem

Discard the vial immediately and contact your prescriber for a replacement

If you receive a vial that looks damaged, overheated, or has ice packs that have melted, contact the pharmacy immediately for further guidance

Some patients note dose-dependent nausea during early titration

Ideal candidates typically include adults with type 2 diabetes who have inadequate glycaemic control (HbA1c above individualised target) despite treatment with metformin and/or other oral agents, particularly those with additional cardiovascular or renal risk factors

Sylfirm X results build over 36 months and can be maintained with annual sessions