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Lyophilized (freeze-dried) powder: Room temperature storage: stable for weeks to months depending on peptide Refrigerator storage (2-8 C): stable for months to over a year Freezer storage (-20 C): stable for years in some cases Keep sealed, dry, and away from light Moisture is the primary enemy of lyophilized peptides Reconstituted solution: Must be refrigerated at 2-8 C at all times Typical stability: 4-6 weeks for most peptides Never freeze reconstituted solutions Use bacteriostatic water (not sterile water) for multi-use vials Each needle puncture introduces contamination risk The difference in stability is dramatic

Recent guidelines from the American Gastroenterological Association suggest that most patients can continue their GLP-1 medications before elective endoscopy procedures

Given the increasing real-world use of combined therapy and the limited HF-specific evidence base, this review summarizes current data regarding the comparative and combined effects of GLP-1 receptor agonists and SGLT2 inhibitors in HF, with emphasis on efficacy, safety, mechanistic rationale, and evidence gaps

Across the three doses of tirzepatide, all patients achieved this composite endpoint in a significantly greater percent compared to patients on semaglutide, with a satisfactory safety profile [25]