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vomiting

Emesis as a reported adverse event: trial incidence, its relationship to dose escalation rate, dehydration risk, and when it stops being a tolerability issue and becomes a clinical one.

14 questions · sorted by votes

56 votes 3 answers32k views
At what point does vomiting on a GLP-1 agonist stop being a tolerability issue and become a clinical problem?

I have vomited three times in the last ten days, always in the twenty-four to forty-eight hours after my injection, always in the morning, and each time I felt…

vomiting
vomiting

Emesis as a reported adverse event: trial incidence, its relationship to dose escalation rate, dehydration risk, and when it stops being a…

14 questions
gi-side-effects
gi-side-effects

The gastrointestinal cluster as a whole - nausea, vomiting, diarrhoea, constipation, reflux, early satiety - with trial incidence rates, dropout…

416 questions
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eGFR, creatinine, cystatin C and albuminuria: the acute haemodynamic dip that is not injury, the renal outcome data from the FLOW programme, and…

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hydration

Fluid intake when thirst and intake cues are both blunted: how much of the early scale drop is fluid, how dehydration confounds a renal panel, and…

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asked by nine_point_nine 45k · 21 months ago
49 votes 3 answers23k views
My creatinine is up and eGFR down after two bad weeks. How much of that is dehydration rather than kidney damage?

Background: eight months on tirzepatide, uneventful until a bad fortnight of vomiting and diarrhoea after a dose increase, during which I ate very little and drank…

kidney-function
kidney-function

eGFR, creatinine, cystatin C and albuminuria: the acute haemodynamic dip that is not injury, the renal outcome data from the FLOW programme, and…

100 questions
bloodwork
bloodwork

Laboratory monitoring: which panels are worth ordering, sensible intervals, reference-range versus optimal-range arguments, and how to read a…

284 questions
vomiting
vomiting

Emesis as a reported adverse event: trial incidence, its relationship to dose escalation rate, dehydration risk, and when it stops being a…

14 questions
hydration
hydration

Fluid intake when thirst and intake cues are both blunted: how much of the early scale drop is fluid, how dehydration confounds a renal panel, and…

14 questions
asked by mg_per_ml 12k · 4 months ago
45 votes 3 answers14k views
Why has my grip and absolute strength fallen off a cliff when my DEXA shows almost no lean-mass loss?

Down 19 kg over seven months on semaglutide. My DEXA says I have lost 1.4 kg of lean soft tissue, which everyone tells me is a good result. But in the gym I am…

resistance-training
resistance-training

Loaded training as the primary intervention for retaining lean mass in a deficit: minimum effective dose, frequency versus volume, and why…

40 questions
lean-mass
lean-mass

Lean body mass as measured rather than assumed: what DEXA, BIA and air-displacement plethysmography each actually estimate, the body-composition…

164 questions
fatigue
fatigue

Tiredness on treatment: how much is energy deficit, how much is dehydration or electrolyte drift, how much is genuinely drug-attributable, and…

38 questions
dexa
dexa

Dual-energy X-ray absorptiometry: what it measures, its precision limits, why hydration state and scan positioning move the numbers, and how to…

84 questions
vomiting
vomiting

Emesis as a reported adverse event: trial incidence, its relationship to dose escalation rate, dehydration risk, and when it stops being a…

14 questions
asked by samir_bennani 13k · 12 months ago
43 votes3 answers18k views
How do I distinguish drug-related constipation from something obstructive, given both present as not going?

I have had slow bowels since starting semaglutide and I have accepted that as the trade. Last week was different and it frightened me: four days with nothing, a hard…

constipation
constipation

Slowed transit as a consequence of delayed gastric emptying and reduced intake: incidence figures, fibre and hydration evidence, and why it often…

14 questions
gi-side-effects
gi-side-effects

The gastrointestinal cluster as a whole - nausea, vomiting, diarrhoea, constipation, reflux, early satiety - with trial incidence rates, dropout…

416 questions
vomiting
vomiting

Emesis as a reported adverse event: trial incidence, its relationship to dose escalation rate, dehydration risk, and when it stops being a…

14 questions
harm-reduction
harm-reduction

Reducing avoidable risk where a decision has already been made: independent verification before use, sterility practice, dose arithmetic checked…

445 questions
asked by grainne_ahearn 13k · 6 months ago
37 votes3 answers15k views
What proportion of trial participants actually stopped because of GI events, and how does that compare to real-world dropout?

I am trying to calibrate how likely it is that GI side effects end up being the reason someone stops, as opposed to being an unpleasant thing they get through. The…

gi-side-effects
gi-side-effects

The gastrointestinal cluster as a whole - nausea, vomiting, diarrhoea, constipation, reflux, early satiety - with trial incidence rates, dropout…

416 questions
discontinuation
discontinuation

Stopping treatment: tapering versus abrupt cessation, what the trial withdrawal arms measured, clinically driven stops, and the practical planning…

21 questions
clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
vomiting
vomiting

Emesis as a reported adverse event: trial incidence, its relationship to dose escalation rate, dehydration risk, and when it stops being a…

14 questions
sarcopenia
sarcopenia

Clinically meaningful loss of muscle mass and function, particularly in older adults on treatment. Distinguishing a proportional reduction from a…

14 questions
asked by ellis_thorne 17k · 13 months ago
30 votes 5 answers35k views
Does holding at 60 mg for eight weeks before escalating reduce early satiety?

Setup, so nobody has to ask: 60 mg · eight weeks · early satiety. The empirical answer seems settled. The explanation does not. If the honest answer is that nobody…

titration
titration

Stepwise dose increases over weeks, why the label schedules exist at all, and what tolerability-driven deviation from a schedule looks like in…

444 questions
nausea
nausea

The dominant tolerability signal in every trial of the class: incidence, timing relative to a dose step, duration, and the distinction between…

346 questions
dose-escalation
dose-escalation

The decision to move up a step: what evidence supports a four-week interval, what happens when you compress it, and how trial protocols handled…

88 questions
vomiting
vomiting

Emesis as a reported adverse event: trial incidence, its relationship to dose escalation rate, dehydration risk, and when it stops being a…

14 questions
asked by imani_dube 19k · 15 months ago
28 votes 2 answers35k views
What did the placebo arm of STEP 1 report for headache?

The specifics, since they change the answer: STEP 1 · headache. I have the document in front of me and I can read the numbers. What I cannot do is interpret them. I…

clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
gi-side-effects
gi-side-effects

The gastrointestinal cluster as a whole - nausea, vomiting, diarrhoea, constipation, reflux, early satiety - with trial incidence rates, dropout…

416 questions
nausea
nausea

The dominant tolerability signal in every trial of the class: incidence, timing relative to a dose step, duration, and the distinction between…

346 questions
vomiting
vomiting

Emesis as a reported adverse event: trial incidence, its relationship to dose escalation rate, dehydration risk, and when it stops being a…

14 questions
asked by leonid_marchuk 15k · 22 months ago
27 votes 5 answers24k views
Does holding at 8 mg for sixteen weeks before escalating reduce reflux?

What I have: 8 mg · sixteen weeks · reflux. I can predict the outcome but I cannot explain it, which means I will get the next case wrong. I would like to know how…

titration
titration

Stepwise dose increases over weeks, why the label schedules exist at all, and what tolerability-driven deviation from a schedule looks like in…

444 questions
nausea
nausea

The dominant tolerability signal in every trial of the class: incidence, timing relative to a dose step, duration, and the distinction between…

346 questions
dose-escalation
dose-escalation

The decision to move up a step: what evidence supports a four-week interval, what happens when you compress it, and how trial protocols handled…

88 questions
vomiting
vomiting

Emesis as a reported adverse event: trial incidence, its relationship to dose escalation rate, dehydration risk, and when it stops being a…

14 questions
asked by imani_dube 19k · 12 months ago
21 votes0 answers26k views
What is the reported incidence of vomiting at the top studied dose?

It has now persisted for three weeks, which is what moved this from tolerable to worth asking about. This is presented as though it settles something, and I am not…

vomiting
vomiting

Emesis as a reported adverse event: trial incidence, its relationship to dose escalation rate, dehydration risk, and when it stops being a…

14 questions
clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
gi-side-effects
gi-side-effects

The gastrointestinal cluster as a whole - nausea, vomiting, diarrhoea, constipation, reflux, early satiety - with trial incidence rates, dropout…

416 questions
asked by wren_calloway 14k · 2.1 years ago
20 votes5 answers19k views
What does SOUL tell me about injection-site erythema at the 10 mg dose?

What I am working with: SOUL · injection-site erythema · 10 mg. I have read the primary source rather than the summary, which has left me with more questions. I…

clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
gi-side-effects
gi-side-effects

The gastrointestinal cluster as a whole - nausea, vomiting, diarrhoea, constipation, reflux, early satiety - with trial incidence rates, dropout…

416 questions
titration
titration

Stepwise dose increases over weeks, why the label schedules exist at all, and what tolerability-driven deviation from a schedule looks like in…

444 questions
vomiting
vomiting

Emesis as a reported adverse event: trial incidence, its relationship to dose escalation rate, dehydration risk, and when it stops being a…

14 questions
asked by eoin_mcgarry 16k · 7 months ago
18 votes5 answers7.8k views
What is the reported incidence of vomiting on retatrutide in TRIUMPH-1?

What I have: vomiting · retatrutide · TRIUMPH-1. This is presented as though it settles something, and I am not convinced it does. I have two documents that appear to…

gi-side-effects
gi-side-effects

The gastrointestinal cluster as a whole - nausea, vomiting, diarrhoea, constipation, reflux, early satiety - with trial incidence rates, dropout…

416 questions
clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
nausea
nausea

The dominant tolerability signal in every trial of the class: incidence, timing relative to a dose step, duration, and the distinction between…

346 questions
vomiting
vomiting

Emesis as a reported adverse event: trial incidence, its relationship to dose escalation rate, dehydration risk, and when it stops being a…

14 questions
asked by cake_intact 18k · 10 months ago
16 votes3 answers8.3k views
Is dizziness on orforglipron dose-dependent or dose-rate dependent?

What I have: dizziness · orforglipron. I can predict the outcome but I cannot explain it, which means I will get the next case wrong. I would like to know how…

nausea
nausea

The dominant tolerability signal in every trial of the class: incidence, timing relative to a dose step, duration, and the distinction between…

346 questions
titration
titration

Stepwise dose increases over weeks, why the label schedules exist at all, and what tolerability-driven deviation from a schedule looks like in…

444 questions
gi-side-effects
gi-side-effects

The gastrointestinal cluster as a whole - nausea, vomiting, diarrhoea, constipation, reflux, early satiety - with trial incidence rates, dropout…

416 questions
vomiting
vomiting

Emesis as a reported adverse event: trial incidence, its relationship to dose escalation rate, dehydration risk, and when it stops being a…

14 questions
asked by Dr_Marek_Zielinski 39k · 6 months ago
2 votes 2 answers1.7k views
Does reflux at week seven of oral semaglutide usually resolve without a dose change?

Details up front: reflux · seven · oral semaglutide. I would like to understand the steps well enough to explain them to someone else. I have access to a refrigerator…

gi-side-effects
gi-side-effects

The gastrointestinal cluster as a whole - nausea, vomiting, diarrhoea, constipation, reflux, early satiety - with trial incidence rates, dropout…

416 questions
titration
titration

Stepwise dose increases over weeks, why the label schedules exist at all, and what tolerability-driven deviation from a schedule looks like in…

444 questions
nausea
nausea

The dominant tolerability signal in every trial of the class: incidence, timing relative to a dose step, duration, and the distinction between…

346 questions
vomiting
vomiting

Emesis as a reported adverse event: trial incidence, its relationship to dose escalation rate, dehydration risk, and when it stops being a…

14 questions
asked by liam_bracken 12k · 6 months ago
1 vote5 answers4.5k views
Does constipation at week two of semaglutide usually resolve without a dose change?

Stated plainly: constipation · two · semaglutide. Everything I have found on this is either a forum aside or a product page, neither of which I trust. I am…

gi-side-effects
gi-side-effects

The gastrointestinal cluster as a whole - nausea, vomiting, diarrhoea, constipation, reflux, early satiety - with trial incidence rates, dropout…

416 questions
titration
titration

Stepwise dose increases over weeks, why the label schedules exist at all, and what tolerability-driven deviation from a schedule looks like in…

444 questions
nausea
nausea

The dominant tolerability signal in every trial of the class: incidence, timing relative to a dose step, duration, and the distinction between…

346 questions
vomiting
vomiting

Emesis as a reported adverse event: trial incidence, its relationship to dose escalation rate, dehydration risk, and when it stops being a…

14 questions
asked by mass_shift_18 14k · 5 months ago
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