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Contact your GP or diabetes specialist if you experience: Persistent or severe nausea and vomiting that prevents adequate fluid or food intake, as this may lead to dehydration and acute kidney injury Signs of dehydration , including reduced urination, dark urine, dizziness, or extreme thirst Unexplained weight loss beyond what is expected or desired Symptoms of hypoglycaemia (low blood sugar), especially if taking Rybelsus alongside insulin or sulfonylureassymptoms include trembling, sweating, confusion, rapid heartbeat, and hunger A lump in the neck, hoarseness, difficulty swallowing, or shortness of breath (which should be promptly evaluated by your GP) Changes in vision or worsening of existing eye problems , particularly if you have diabetic retinopathy Seek urgent same-day medical assessment (via GP, NHS 111, or A&E) if you develop: Symptoms suggestive of acute pancreatitis : severe, persistent abdominal pain with or without vomiting, particularly if radiating to the back Biliary-type pain or jaundice (yellowing of the skin or whites of the eyes) Call 999 or attend A&E immediately if you develop: Signs of a serious allergic reaction : difficulty breathing, swelling of the face, lips, tongue, or throat, or severe skin reactions Severe symptoms with collapse or extreme distress Regular monitoring is essential for all patients on Rybelsus

Metformin dosing typically remains unchanged unless your doctor identifies side effects or your kidney function changes

The lotion is designed to promote absorption of the active ingredients into the skin for localized treatment

Gillespie, S