Despite GIP-R agonism having been linked to enhanced glucagon levels [40], treatment with all doses tirzepatide have surprisingly been associated with significantly reduced levels of fasting glucagon more than placebo [76] and dulaglutide [74]
Important safety note Like GLP-1 receptor agonists, CagriSema is contraindicated in people with a personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
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Insomnia is not listed as an adverse reaction in the MHRA Summary of Product Characteristics, though some patients report sleep disturbances
Combined effect is plausibly greater