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For patients concurrently taking metformin, periodic B12 monitoring should be considered , particularly if you have been on metformin for several years or have symptoms of deficiency, in line with MHRA and NICE recommendations

The maintenance frequency approach where intensive initial treatment transitions to reduced ongoing application (2-4 times weekly) provides middle ground sustaining benefits while minimizing costs and commitment intensity

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If you miss three or more doses of tirzepatide consecutively, your healthcare provider may recommend lowering your dosage or restarting the dose escalation process at 5 mg weekly