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Pre-mixed formulations have already been reconstituted by the pharmacy, which means the 28-day (or longer, depending on the BUD) countdown began the moment it was compounded, not when you received it

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Switching is common when: Side effects on the first drug are intolerable The first drug doesn't produce expected weight loss or A1C reduction at maximum tolerated dose Insurance coverage changes Cost on the first drug becomes unsustainable When switching: The new drug usually starts at its lowest dose, not at an "equivalent" higher dose

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He advises patients to avoid unknowns in the first trimester, the riskiest time of pregnancy