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Both insulin and IGF-1 are growth-stimulating and anabolic hormones, and insulin and IGF receptor activation upregulates pathways central to carcinogenesis (see Figure 2)

Consider switching to a non-oral method or adding a barrier method of contraception for 4 weeks after initiation and 4 weeks after each dose escalation

Per the UK SmPC/PIL, approved sites for GLP-1 receptor agonists are the abdomen, thigh, and upper arm