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Gall bladder/bile duct disease Acute pancreatitis and other pancreatic disorders have been reported, though the relationship to treatment is unclear Injection-site reactions Dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist Primary mechanism(s) of action Selectively binds and activates both GIP and GLP-1 receptors Example Tirzepatide (Mounjaro) Dosage Initial: 2.5 mg subcutaneous injection once weekly, titrated up to 5 mg weekly after 4 weeks If additional glycemic control is needed, dosage can be increased in 2.5 mg increments after at least 4 weeks on the current dosage

SELEX undergoes multiple selection rounds to nature specific aptamer sequence and it normally took around 1015 cycles shown in Figure 2 (65)

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