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Contact your healthcare provider within 2448 hours if you experience: Persistent vomiting : Inability to keep down fluids for more than 24 hours, which may lead to dehydration Severe abdominal pain : Particularly sharp, constant pain in the upper abdomen that may radiate to the back, which could indicate pancreatitis Visual changes : Blurred vision or difficulty focusing, especially in patients with pre-existing diabetic retinopathy Signs of dehydration : Decreased urination, dark urine, dizziness upon standing, or extreme thirst Persistent diarrhea : Lasting more than 48 hours or accompanied by fever Pregnancy or planning pregnancy : Weight management formulations are contraindicated during pregnancy [1] [2] Seek immediate emergency care for: Severe allergic reactions : Difficulty breathing, throat swelling, widespread rash, or rapid heart rate Symptoms of pancreatitis : Severe, persistent abdominal pain (often radiating to the back), accompanied by nausea and vomiting Signs of gallbladder disease : Sudden severe pain in the right upper abdomen, particularly after eating fatty foods, with or without fever Symptoms of hypoglycemia (in patients taking insulin or sulfonylureas concurrently): Severe shakiness, confusion, loss of consciousness, or seizures Signs of intestinal obstruction : Severe abdominal distension, persistent inability to pass stool or gas, vomiting Symptoms of acute kidney injury : Markedly decreased urine output, swelling of legs or feet, especially with severe dehydration Thyroid-related symptoms : New lump or swelling in the neck, hoarseness, difficulty swallowing, or shortness of breath Additionally, contact your provider if you experience unexplained mood changes, depression, or suicidal thoughts