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Multi-dose vials that are accessed repeatedly over days or weeks accumulate contamination risk with each needle insertion

In June 2025, the European Medicines Agency (EMA) officially confirmed that NAION is a very rare side effect of semaglutide drugs, recommending urgent updates to product labeling and treatment protocols

This delayed digestion can create conditions where hydrogen sulphide gas forms, producing the characteristic rotten egg odour of sulphur burps

This means its side-effect profile can be different from that of Januvia alone - particularly as metformin can cause stomach upset or diarrhea especially when treatment first begins