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The conflicting evidence in the current literature highlights the urgent need for larger prospective studies to more accurately quantify the risk of NAION, as well as the development of clear, evidence-based monitoring guidelines

Options include (a) the conservative 2.5 mg 5 mg path or (b) start at 5 mg if prior GLP-1 tolerance was excellent and the clinician prefers not to de-titrate. In either case, escalate by 2.5-mg increments no faster than every 4 weeks, pausing or stepping back if nausea, vomiting, or dehydration appear

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