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Clinicians usually increase the dose gradually over several weeks depending on tolerance and response

Cardiorenal end points in a trial of aliskiren for type 2 diabetes

Practical counselling points The oral formulation introduces administration requirements that differ meaningfully from the injectable, and these should form a core part of counselling for anyone switching: The tablet must be taken on an empty stomach, first thing in the morning (minimum 8 hours of fasting), with no more than a small glass (up to 120ml) of plain water

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Each dose increase brings a new wave of receptor activation, and with it, a new phase of appetite suppression, metabolic changes, and potential side effects