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Gastrointestinal effects and referred pain: The pronounced gastrointestinal side effects of GLP-1 therapyparticularly nausea, constipation, and abdominal distensioncan occasionally manifest as referred pain to the back

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Express Scripts defines medical necessity in its prior authorization criteria (the BMI thresholds, step therapy requirements, and comorbidity documentation described above)

Other experimental agents use nasal spray for mucosal uptake