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Factors that may increase susceptibility to vomiting include rapid dose escalation, consuming large or high-fat meals, pre-existing gastroparesis or other motility disorders, and concurrent use of other medications that affect gastric emptying (such as opioids, anticholinergics, or other GLP-1/GIP agents)

Neurogastroenterol Motil 18 : 392400 Nakamura K et al

The standard reconstitution protocol calls for directing the diluent gently down the side of the vial, allowing it to contact the lyophilized cake gradually rather than blasting it with a direct stream

For others, the safer first step may be labs, lifestyle counseling, treatment of sleep apnea, medication review, or addressing a medical driver of weight gain