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Hold for 30-90 seconds before swallowing

Potential concerns include: Gallbladder disease Acute pancreatitis Dehydration related to prolonged vomiting Kidney complications secondary to dehydration Boxed warning regarding thyroid C-cell tumors based on rodent studies Patients with a personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2 (MEN2) generally should not use these medications

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The clinical criteria for medical review are attached

Summary: Small air bubbles in GLP-1 injection pens are not dangerous when administered subcutaneously and are commonly present due to manufacturing or storage, though removing larger bubbles ensures accurate dosing