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For new patients starting semaglutide who are also being prescribed metformin for the first time, the standard sequence is metformin 500 mg twice daily for 2 weeks, then 1000 mg twice daily, then add semaglutide 0.25 mg weekly starting around week 4 of metformin therapy

Discuss with your provider how often to recheck thyroid function during GLP-1 initiation, and ensure levothyroxine timing is separated from any other medications that could interfere with absorption

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