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Can You Take Januvia and Rybelsus Together

Dehydration risk : GI side effects from semaglutide may increase the risk of dehydration, which can in turn increase the risk of kidney stones with topiramate

If you feel great at 4mg and want to move faster, you can consider a 3-week block at the next dose instead of 4, but never skip a dose level entirely

Consider bigger lifestyle changes : GLP-1s work best when paired with a healthy diet (which helps you lose the weight) and regular exercise (to keep the weight off)