Patients who unknowingly receive unapproved formulations may face challenges if complications arise, including lack of liability recourse, absence of pharmacologic data, and difficulty receiving support from traditional pharmacies or insurers
However, several products do allow limited room temperature storage before first use according to their FDA labels: Wegovy (semaglutide): Up to 28 days at or below 86F (30C) before use Trulicity (dulaglutide): Up to 14 days at or below 86F (30C) before use Mounjaro and Zepbound (tirzepatide): Up to 21 days at or below 86F (30C) before use Bydureon BCise (exenatide extended-release): Up to 4 weeks at or below 77F (25C) before use When storing unopened GLP-1 medications, patients should keep them in their original carton to protect them from light exposure, which can also degrade the active ingredient
A meta-analysis found glucose-lowering drugs outperform probiotics on blood sugar, while probiotics added benefits for lipids and blood pressure
Can J Cardiol 2018;34:1350-61
Clinicians have raised alarms about this shift
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