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If your current formulation uses cyanocobalamin and you're not seeing expected results, switching to a methylcobalamin-based formula is reasonable

The vision complications are rare, and more research needs to be done. NAION is a very rare side effect of semaglutide (Ozempic), affecting up to 1 in 10,000 patients, according to the report

Alternative therapies in health and medicine, 30 (10), 1217

These updated warnings include further advice for patients using oral contraceptives: Patients taking tirzepatide are advised to switch to a non-oral contraceptive or add a barrier method of contraception for 4 weeks after first taking the medicine and for 4 weeks after each increase in the dose