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However, repeated or vigorous shaking can physically break the peptide bonds, a process called mechanical shearing

& Gershengorn, M

Mildly acidic solutions such as dilute acetic acid are sometimes used for peptides that resist dissolving, while a few require a very small volume of sodium hydroxide or a similar agent

The actual transition timeline should be individualized based on your response to both medications, your weight loss trajectory, and your side effect profile

A licensed medical provider such as a PA, NP, MD, or DO can help determine whether treatment is appropriate and provide follow-up around side effects, dosing, nutrition, activity, and overall medical safety