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Put the needle through the rubber top of the vial and push the plunger to inject the air into the vial

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People with certain heart, kidney or liver conditions who are on fluid restriction should follow their healthcare professional's specific advice about fluid intake

That's bad news for long-term health

Baseline kidney function testing is advisable before starting treatment and periodically during use

Other notable adverse effects include: Injection site reactions such as erythema, pruritus, or swelling Fatigue reported in approximately 5% to 6% of patients Hypoglycemia when used in combination with insulin or sulfonylureas Increased heart rate with modest elevations of 2 to 4 beats per minute (a class effect of incretin therapies with uncertain clinical significance) Serious but rare adverse effects include acute pancreatitis, gallbladder disease (cholelithiasis, cholecystitis), acute kidney injury (typically secondary to dehydration from gastrointestinal symptoms), and hypersensitivity reactions