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The regulatory landscape has shifted significantly, with the FDA removing tirzepatide from the drug shortage list and restricting compounding under certain conditions

Additionally, some research suggests chronic GLP-1 agonist use may reduce gastric acid secretion over time, though this finding remains controversial

Aoyama T, Maezawa Y, Cho H, Saigusa Y, Tamura J, Tsuchida K, Komori K, Kano K, Segami K, Hara K, Senuki K, Suzuki Y, Yamakawa M, Tamagawa H, Oshima T, Yukawa N, Rino Y

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Therapeutic anticoagulation, active autoimmune disease, or concurrent corticosteroids