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The most serious risk, lactic acidosis, is extremely rare (estimated at 1-5 cases per 100,000 patient-years) and occurs almost exclusively in patients with severe kidney impairment or acute illness
When Not to Take Byetta as useful as Byetta and Bydureon are at controlling blood sugar levels, these medications are not for everyone
Full publication of combination-therapy data is awaited, however interim analysis from the phase II COURAGE trial (NCT06299098) found 3.3% reduction in lean mass of obese patients treated with the combination of trevogrumab and semaglutide, compared with 6.5% reduction with semaglutide alone [70]
However, the SmPC does specifically note that patients on warfarin or other coumarin derivatives should have their INR monitored when initiating semaglutide treatment, as a precautionary measure