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While off-licence prescribing can be common in some areas of medicine [60], it can also pose safety risks [61]particularly when medications are accessed without appropriate clinical supervision

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Serious adverse events with tirzepatide are rare but include pancreatitis, gallbladder problems, and potential thyroid concerns (based on animal studies)

Consequently, it was not possible to identify individual patients or healthcare providers

This information will help reduce the risk of any drug interactions or adverse reactions

For patients with type 2 diabetes and ASCVD, starting a GLP-1 RA carries a Class 1, Level of Evidence A recommendation in the most recent ESC and ACC guidelines