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Persistent foam is not

Combination with Insulin with or without Metformin In a 26-week double blind trial (Trial 6, NCT03021187), 731 adult patients with type 2 diabetes mellitus inadequately controlled on insulin (basal, basal/bolus or premixed) with or without metformin, were randomized to semaglutide tablets 3 mg, 7 mg and 14 mg orally once daily or placebo once daily

What came in the packaging was the dose you took

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Pull off the outer cap and then the inner cap