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Patients should contact their GP or diabetes specialist nurse if they experience: Severe or persistent vomiting that prevents adequate fluid or food intake, as this increases the risk of dehydration and hypoglycaemia Severe abdominal pain , particularly if constant or radiating to the back, which could indicate pancreatitisa rare but serious adverse effect of GLP-1 receptor agonists Sudden pain in the right upper abdomen, fever or jaundice , which may indicate gallbladder problems (cholelithiasis or cholecystitis) Blood in stools or black, tarry stools Unexplained weight loss beyond what is expected from the medication's therapeutic effect Signs of dehydration , including reduced urine output, dizziness, or confusion Persistent diarrhoea lasting more than a few days Symptoms that significantly impair quality of life or prevent adherence to the medication regimen Pancreatitis is a particular concern with semaglutide, though it remains uncommon

Unfortunately, one of those named pharmacies, BPI Labs, is carrying unresolved FDA action that includes a recent pause on compounded GLP-1s