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Cardiovascular signs such as arrhythmias and bradycardia are also common in this stage

This product is not approved by the FDA for human consumption, medical use, or veterinary use

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The dosing guidance below is synthesized from pharmacokinetic data, practitioner consensus, and small clinical series

Tier 1: A BMI of 35 or higher (no other qualifying conditions) Tier 2: A BMI of 30 or higher one of the following qualifying conditions: Heart failure (preserved ejection fraction), Uncontrolled hypertension (despite 2+ medications), Chronic kidney disease (Stage 3a or higher) AND Tier 3: A BMI of 27 or higher one of the following qualifying conditions: Pre-diabetes, Prior heart attack, Prior stroke, Peripheral artery disease AND 3