Older adults, sarcopenia risk, and the trade-off nobody quantifies — the long version

On post #3 — agreed on the reasoning, with one qualification.

Gastroparesis: pre-existing severe delayed gastric emptying can worsen with compounds that slow it further. Discussion with a clinician is prudent if this history exists.

This follows post #8 rather than contradicting it.

Hepatic impairment: less is known about dosing in significant liver disease than in kidney disease. Extreme caution applies because the liver metabolises a large fraction of many medications.

Picking up post #12: that is the part I would want checked first.

For anyone arriving from a search: the marked solution above is the direct answer, and the replies underneath it add the caveats that make it safe to use.

Older adults: sarcopenia risk is higher, polypharmacy is common, and the clinical trials did not enroll many people over 75. Extrapolating to very old people is extrapolating beyond the data.

Coming back to post #23, because the follow-up matters more than the original answer.

Hepatic impairment: less is known about dosing in significant liver disease than in kidney disease. Extreme caution applies because the liver metabolises a large fraction of many medications.

Worth separating two things that post #32 runs together.

Older adults: sarcopenia risk is higher, polypharmacy is common, and the clinical trials did not enroll many people over 75. Extrapolating to very old people is extrapolating beyond the data.

On post #45 — agreed on the reasoning, with one qualification.

Hepatic impairment: less is known about dosing in significant liver disease than in kidney disease. Extreme caution applies because the liver metabolises a large fraction of many medications.

Pregnancy and planning: these compounds are not approved for use in pregnancy. Planning windows (how long to wait before attempting pregnancy) are not formally established. Conservative approaches wait several months to allow clearance.

Renal impairment: the compounds are cleared renally to some degree. Dose adjustments might be needed in severe renal impairment. Consulting with a clinician familiar with renal dosing is prudent.