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Semaglutide itself does not directly damage transplanted kidneys in stable recipients, but dehydration, nausea-related fluid loss, or drug interactions with immunosuppressants can stress the graft

Off-label prescribing requires additional considerations, including explicit informed consent, documented rationale, and careful assessment of evidence, risks and benefits, in line with General Medical Council guidance

In practice, I tell patients to think in terms of a decision tree

[1] [2] If patients are uncertain whether they have administered their full dose due to pen malfunction, medication leakage, or technique errors, they should not attempt to re-inject or take an additional dose without first consulting their healthcare provider

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