About the Contraindications category

Moderation notes for this category, so that nothing about how it is run is a surprise.

Topics get moved into and out of here regularly. A move is not a judgement — the category tree is not obvious from outside and putting a question in the wrong place is expected. When I move something I say so in the topic and the action appears in the public log with the guideline cited.

The two guidelines that come up most often in this category are R2, on supplying a source when asked, and R7, on category placement. Neither is used punitively.

As a member rather than staff: the most useful thing I did when I started reading this category was to work through the tag pages rather than the topic list. The topic list shows you what is recent. The tags show you what is settled.

Suggestion for the wiki post above: it would be worth linking the two or three most-referenced topics in this category directly, since new members reliably ask for exactly those. Happy to make the edit myself if nobody objects, with a revision note.

History of pancreatitis: these compounds can rarely trigger pancreatitis. History of pancreatitis increases relative risk. That is a relative contraindication, not absolute, but requires monitoring.

post #5 is right about the mechanism and I think understates the practical bit.

I disagree with the reply above, and I think the disagreement is substantive rather than terminological.

The distinction being drawn does not survive when you look at the published data for this specific question. I would be glad to be shown wrong on this, because the version I am arguing against is more convenient.

Concurrent insulin or sulfonylureas: not an absolute contraindication but requires dose adjustment and close monitoring for hypoglycemia. The combination is used with caution, not avoided.

Gastroparesis or severe delayed gastric emptying: these compounds slow gastric emptying. Pre-existing severe gastroparesis can be worsened. That is a relative contraindication depending on baseline severity.

Practical note that does not fit anywhere else. Whatever you conclude from this topic, write down what you did and when. The single most useful thing in your own records is not any individual result; it is that they are dated and consecutive.

post #9 answers the question as asked. The question underneath it is different.

Severe renal impairment (eGFR <15): these compounds are renally cleared and accumulate in severe kidney disease. Risk-benefit is unfavourable without dose adjustment.

Disordered eating history: appetite suppression can trigger relapse in people with history of anorexia, bulimia, or other eating disorders. This is a relative contraindication requiring specialist input.