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Avoid creatine hydrochloride, buffered creatine, or liquid creatine, as none have superior evidence and some may cause more GI issues

Prescription Monitoring: Many states participate in Prescription Drug Monitoring Programs (PDMPs): Track all prescription medications Providers may need to check before prescribing Helps prevent medication abuse Semaglutide is not controlled but may still be tracked Interstate Medical Licensure: Medical Licensure Compact: Some states participate in compacts allowing expedited licensing across states: Makes it easier for providers to practice in multiple states Not all states participate Provider still needs individual state licenses Pharmacy Compacts: Similar agreements exist for pharmacies to operate across state lines

Tablets should be uniform in appearance within each strength

However, the landmark SURMOUNT-5 trial (published in mid-2025), which compared the two medications head-to-head, clarified the clinical reality: Total Weight Loss: Tirzepatide drives significantly greater total weight loss (averaging over 20%) compared to semaglutide (averaging roughly 14%)