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Gastrointestinal adverse effects of GLP-1 agonistsincluding nausea, vomiting, and dehydrationcould be exacerbated by alcohol use and may complicate medication adherence

In animal models of diabetes, the authors show that co-administration of a lipid-lowering drug with a dipeptidyl peptidase-4 inhibitor or a glucagon-like peptide-1 agonist improved glucose tolerance and beta cell mass

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Theres also the issue of tolerance

Patients should seek urgent medical attention if they experience: Severe or persistent abdominal pain (possible pancreatitis or gallbladder complication) Signs of dehydration (dizziness, reduced urine output) due to vomiting or diarrhoea Symptoms of hypoglycaemia (shakiness, sweating, confusion) or hyperglycaemia (excessive thirst, frequent urination) Severe headache or visual disturbance (possible raised intracranial pressure) Signs of an allergic reaction (rash, swelling, difficulty breathing) Regular monitoring should include fasting glucose, HbA1c, IGF-1, lipid panels, liver function, and renal function