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These include temporary skin redness, itch, or irritation after topical application, reported in a small percent of users, single-digit percentages in trials

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patients should be advised to seek immediate medical attention for severe, persistent abdominal pain Gallbladder disease : cholelithiasis and cholecystitis have been reported with GLP-1 receptor agonists Diabetic retinopathy complications : particularly in patients with pre-existing retinopathy who experience rapid improvement in glucose control Common adverse effects of Januvia include: Upper respiratory tract infections and nasopharyngitis Headache and gastrointestinal disturbances (though generally milder than with GLP-1 agonists) Rare but serious risks : acute pancreatitis, severe joint pain, hypersensitivity reactions, and bullous pemphigoid (a serious skin condition) When used together, there is a theoretical increased risk of gastrointestinal side effects , particularly nausea, as both medications influence gut hormone pathways

A joint position paper by the World Heart Federation and World Obesity Federation