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Absolute contraindications: Known allergy to either peptide or its components Active cancer (insufficient safety data) Pregnancy or breastfeeding (insufficient safety data) Severe immunocompromise (theoretical concern) Relative contraindications (require careful consideration): History of cancer (consult a medical advisor) Major cardiac disease (monitor closely) Severe liver or kidney disease (may affect clearance) Active infections (wait until resolved) Bleeding disorders (monitor injection sites carefully) Special populations: Elderly subjects: usually well tolerated, no dose adjustment needed Subjects with multiple conditions: enhanced monitoring recommended Those on multiple medications: review for possible interactions Drug Interactions The peptides have minimal documented drug interactions

Important precautions Hypercalcaemia (high blood calcium) Do not take vitamin D if you have high levels of calcium in your blood or urine, as it can lead to serious complications including kidney damage and heart rhythm issues

Phase (approx.) Cagrilintide dose Frequency Weeks 14 0.25 mg Once weekly Weeks 58 0.5 mg Once weekly Weeks 912 1.0 mg Once weekly Weeks 1316 1.7 mg Once weekly Week 17 onward 2.4 mg (max studied) Once weekly This step-wise schedule mirrors the titration used in cagrilintide and CagriSema studies ( Lau et al., Lancet 2021

Paradoxically, copper deficiency worsens HF