However, a TUE for nebulized salbutamol would be granted only in rare situations, such as a severe acute asthma attack treated in an emergency room setting
Protocol 1: Maximum weight loss (aggressive) Goal: Lose 50-80+ lbs in 12-18 months Approach: Semaglutide: Titrate to 2.4mg weekly over 16 weeks Cagrilintide: Titrate to 2.4mg weekly over 12 weeks (starting week 5) Both at maximum approved doses Maintain for 12-18 months Supporting strategies: High-protein diet (1g per lb goal weight) Resistance training 3-4x weekly 10,000+ steps daily Sleep 7-9 hours Stress management Expected results: Month 6: 30-45 lbs lost Month 12: 50-70 lbs lost Month 18: 60-85 lbs lost Percentage: 20-25% body weight Cost: $6,000-12,000 total Protocol 2: Conservative approach (better tolerated) Goal: Steady weight loss with minimal side effects Approach: Semaglutide: Titrate to 1.7mg weekly over 20 weeks Cagrilintide: Titrate to 1.8mg weekly over 16 weeks Slower escalation Lower maintenance doses Benefits: Reduced GI side effects Better tolerability Easier to sustain More affordable Expected results: Month 12: 35-50 lbs lost Percentage: 15-20% body weight Better adherence long-term Cost: $5,000-8,400/year Protocol 3: Adding cagrilintide to existing semaglutide Goal: Break through plateau on semaglutide Approach: Already on semaglutide 2.4mg (or lower) Add cagrilintide starting at 0.6mg weekly Titrate cagrilintide to 2.4mg over 12 weeks Continue both Timeline: Plateau broken within 4-8 weeks of adding cagrilintide Additional 10-20 lbs lost over 6-12 months Renewed progress Who this helps: Plateaued on semaglutide alone Lost initial weight but stuck Want to avoid stopping semaglutide Protocol 4: Maintenance after goal weight Goal: Maintain weight loss long-term Approach: Reduce to maintenance doses: Semaglutide: 1.0-1.7mg weekly Cagrilintide: 1.2-1.8mg weekly Monitor weight weekly Adjust up if regaining Benefits: Lower cost Fewer side effects Sustainable long-term Prevents regain Duration: Indefinite (may need lifelong) See our peptide cycle planning guide and can you cycle different peptides
PASCOE b12 depot- package of 10 -1.5mg x 1ml ampoules Pharmaceutical reference number0756 8672 Packets of 10 x 10 1.5mg x 1mg ( 100 ampoules) pharmaceutical reference number 0756 8695 The Pascoe are much cheaper per packet if you buy the offer of 10 packets
The need for vitamin B12 is increased by pregnancy and lactation
Matek et al
Nature, 432(7016), 466-472
