While there's no evidence that expired semaglutide becomes toxic, the lack of safety data means you're taking an unknown risk
Weinheimer, Lisa P
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Moderate deficiency may include obvious macrocytic anemia, glossitis, as well as some mild or subtle neurological features, such as distal sensory impairment.[] Severe deficiency is characterized by bone marrow suppression, neurological features, and the risk of cardiomyopathy
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Monitoring plan: Weight, glucose, hydration, bowel habits, and symptoms