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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.

57 questions · sorted by votes · page 1 of 3

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…

57 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…

162 questions
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…

141 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 nine_point_nine 60k · 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…

141 questions
bloodwork
bloodwork

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

296 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…

57 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 15k · 4 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…

55 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…

162 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…

57 questions
harm-reduction
harm-reduction

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

472 questions
asked by grainne_ahearn 50k · 6 months ago
41 votes5 answers70k views
What is the reported incidence of vomiting on retatrutide in TRIUMPH-3?

The specifics, since they change the answer: vomiting · retatrutide · TRIUMPH-3. I have the document in front of me and I can read the numbers. What I cannot do is…

vomiting
vomiting

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

57 questions
clinical-trials
clinical-trials

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

745 questions
retatrutide
retatrutide

An investigational GLP-1, GIP and glucagon receptor tri-agonist, studied in the TRIUMPH programme. Not approved anywhere. Use this tag for…

251 questions
asked by Dr_Aoife_Brennan 20k · 2.4 years ago
41 votes 5 answers52k views
Is vomiting on ecnoglutide dose-dependent or dose-rate dependent?

Concretely: vomiting · ecnoglutide. I understand the observation; what I do not understand is the mechanism behind it. I have read the two review articles that come…

vomiting
vomiting

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

57 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…

456 questions
ecnoglutide
ecnoglutide

A long-acting GLP-1 receptor agonist with a cAMP-biased signalling profile. A niche tag, mostly used for mechanism questions about biased agonism…

223 questions
asked by ellis_thorne 17k · 2.1 years ago
39 votes 5 answers19k views
What is the reported incidence of vomiting on oral semaglutide in PIONEER-1?

Details up front: vomiting · oral semaglutide · PIONEER-1. I can parse the result. I am less sure what it licenses me to conclude. I have deliberately not looked at…

vomiting
vomiting

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

57 questions
clinical-trials
clinical-trials

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

745 questions
oral-glp1
oral-glp1

Oral routes for GLP-1 receptor agonism: peptide formulations rescued by absorption enhancers such as SNAC, and true small molecules that need no…

219 questions
asked by two_point_four 8.9k · 21 months ago
38 votes0 answers16k views
What did the placebo arm of STEP 2 report for vomiting?

What I am working with: STEP 2 · vomiting. I would like help reading this properly rather than being told what conclusion to reach. I have the full report including…

clinical-trials
clinical-trials

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

745 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…

57 questions
asked by seamus_brady 15k · 2.0 years 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…

162 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…

745 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…

57 questions
asked by ellis_thorne 17k · 13 months ago
34 votes 4 answers19k views
What did the placebo arm of SUSTAIN-6 report for vomiting?

Setup, so nobody has to ask: SUSTAIN-6 · vomiting. I have read the primary source rather than the summary, which has left me with more questions. I understand the…

clinical-trials
clinical-trials

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

745 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…

57 questions
asked by cap_the_luer 14k · 20 months ago
31 votes5 answers17k views
Does vomiting at week twelve of oral semaglutide usually resolve without a dose change?

The particulars: vomiting · twelve · oral semaglutide. I would like to understand the steps well enough to explain them to someone else. I have access to a…

vomiting
vomiting

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

57 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…

456 questions
oral-glp1
oral-glp1

Oral routes for GLP-1 receptor agonism: peptide formulations rescued by absorption enhancers such as SNAC, and true small molecules that need no…

219 questions
asked by Dr_Ingrid_Baumgartner 73k · 15 months ago
30 votes 5 answers56k views
Is vomiting on survodutide dose-dependent or dose-rate dependent?

What I have: vomiting · survodutide. I understand the observation; what I do not understand is the mechanism behind it. I have read the two review articles that come…

vomiting
vomiting

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

57 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…

456 questions
survodutide
survodutide

A GLP-1 and glucagon receptor dual agonist with a substantial published MASH dataset. Use this tag for its hepatic endpoints, its dose ladder, and…

225 questions
asked by dana_wexler 11k · 2.2 years ago
30 votes 3 answers11k views
What did the placebo arm of SURMOUNT-1 report for vomiting?

Concretely: SURMOUNT-1 · vomiting. The figures are clear enough; the question is what they mean and what they do not. I can supply the numbers if the specifics change…

clinical-trials
clinical-trials

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

745 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…

57 questions
asked by micron22 22k · 11 months ago
29 votes 5 answers30k views
Does holding at 10 mg for sixteen weeks before escalating reduce vomiting?

What I have: 10 mg · sixteen weeks · vomiting. 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…

456 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…

57 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…

103 questions
asked by rukhsana_iqbal 17k · 18 months ago
28 votes5 answers41k views
What did the placebo arm of STEP 8 report for vomiting?

What I am working with: STEP 8 · vomiting. I would like help reading this properly rather than being told what conclusion to reach. I have the full report including…

clinical-trials
clinical-trials

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

745 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…

57 questions
asked by threadlock7 19k · 18 months ago
28 votes5 answers24k views
What does SOUL tell me about vomiting at the 14 mg dose?

Conditions: SOUL · vomiting · 14 mg. I would like to know the limits of what can be inferred from this. What I am trying to avoid is over-reading a single result,…

clinical-trials
clinical-trials

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

745 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…

57 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…

456 questions
asked by nils_karlberg 9.4k · 13 months ago
27 votes0 answers31k views
What does REDEFINE-1 tell me about vomiting at the 2.4 mg dose?

Concretely: REDEFINE-1 · vomiting · 2.4 mg. I would like to know the limits of what can be inferred from this. What I am trying to avoid is over-reading a single…

clinical-trials
clinical-trials

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

745 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…

57 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…

456 questions
asked by t_oyelaran 79k · 2.3 years ago
27 votes3 answers19k views
What did the placebo arm of FLOW report for vomiting?

Concretely: FLOW · vomiting. I have read the primary source rather than the summary, which has left me with more questions. I understand the headline. I do not…

clinical-trials
clinical-trials

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

745 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…

57 questions
asked by plate_count_9k 78k · 10 months ago
26 votes 5 answers62k views
Does holding at 1.7 mg for sixteen weeks before escalating reduce vomiting?

Numbers first: 1.7 mg · sixteen weeks · vomiting. I can predict the outcome but I cannot explain it, which means I will get the next case wrong. I would like to know…

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…

456 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…

57 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…

103 questions
asked by cold_lane 10k · 2.4 years ago
26 votes5 answers42k views
What is the reported incidence of vomiting on tirzepatide in SURMOUNT-1?

Details up front: vomiting · tirzepatide · SURMOUNT-1. This is presented as though it settles something, and I am not convinced it does. I have two documents that…

vomiting
vomiting

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

57 questions
clinical-trials
clinical-trials

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

745 questions
tirzepatide
tirzepatide

A dual GIP and GLP-1 receptor agonist. Questions here cover the SURPASS and SURMOUNT programmes, the practical differences from a pure GLP-1…

370 questions
asked by ruaidhri_o_shea 25k · 22 months ago
26 votes5 answers23k views
What is the reported incidence of vomiting on semaglutide in STEP 1?

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

vomiting
vomiting

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

57 questions
clinical-trials
clinical-trials

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

745 questions
semaglutide
semaglutide

A GLP-1 receptor agonist with a fatty-acid-acylated backbone and a roughly one-week half-life, marketed for type 2 diabetes and for weight…

470 questions
asked by void_volume 9.5k · 20 months ago
26 votes1 answer11k views
Does vomiting at week nine of cagrilintide usually resolve without a dose change?

Concretely: vomiting · nine · cagrilintide. I have read the obvious sources and they disagree with each other, so I would rather ask people who have actually done…

vomiting
vomiting

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

57 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…

456 questions
amylin
amylin

Amylin and its analogues, most prominently cagrilintide, as a satiety mechanism orthogonal to incretin signalling. Includes the pharmacology of…

237 questions
asked by fresh_bac 9.7k · 5 months ago
24 votes0 answers23k views
Does vomiting at week three of tirzepatide usually resolve without a dose change?

For reference: vomiting · three · tirzepatide. I would like to understand the steps well enough to explain them to someone else. I have access to a refrigerator with…

vomiting
vomiting

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

57 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…

456 questions
tirzepatide
tirzepatide

A dual GIP and GLP-1 receptor agonist. Questions here cover the SURPASS and SURMOUNT programmes, the practical differences from a pure GLP-1…

370 questions
asked by coring_risk 27k · 2.2 years ago
24 votes5 answers13k views
Does holding at 15 mg for three weeks before escalating reduce vomiting?

The specifics, since they change the answer: 15 mg · three weeks · vomiting. I would like the mechanism, because I want to be able to reason about the cases 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…

456 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…

57 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…

103 questions
asked by kofi_mensah 18k · 5 months ago
22 votes 5 answers33k views
What does STEP 1 tell me about vomiting at the 2 mg dose?

Stated plainly: STEP 1 · vomiting · 2 mg. I would like help reading this properly rather than being told what conclusion to reach. I have the full report including…

clinical-trials
clinical-trials

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

745 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…

57 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…

456 questions
asked by elke_brunner 17k · 19 months ago
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