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If period changes persist beyond the first six months, become excessively heavy, or are accompanied by severe pain or spotting between cycles, medical evaluation is warranted to rule out other causes unrelated to tirzepatide

This was highlighted when CMS released a Proposed NCD for Pre-Exposure Prophylaxis (PrEP) for Human Immunodeficiency Virus (HIV) Infection Prevention on July 12, 2023

With heparin, risks of maternal haemorrhage and other complications are still increased, but heparins do not cross the placental barrier, so do not cause birth defects