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There are also a few cautions the FDA notes specific to this drug, including but not limited to: risk of pancreatitis hypoglycemia (low blood sugar) when used in conjunction with certain other drugs renal impairment or kidney failure acute gallbladder disease increased risk of thyroid C-cell tumors The FDA notes that patients who have had, or have family members who have had, medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2 should not use liraglutide, nor should individuals who have experienced prior serious hypersensitivity reaction to the drug

The relevant geography is state licensing, not physical distance