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A nasal spray is thus generally easier to administer than an intramuscular or subcutaneous injection

Mechanism semaglutide/tirzepatide: GLP-1 (and GIP) receptor agonism

- Liver enzymes if any preexisting liver concern, given the monkey toxicology signal

For patients without neurological involvement , hydroxocobalamin 1 mg is administered intramuscularly three times a week for 2 weeks, followed by maintenance injections every three months for life (if due to pernicious anaemia or other non-dietary cause)

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