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dose reduction of concomitant medications may be necessary Diabetic retinopathy: Rapid improvement in glycemic control has been associated with temporary worsening of diabetic retinopathy in some diabetes trials Acute kidney injury: Cases have been reported, often in the setting of volume depletion from gastrointestinal adverse effects Gallbladder disease: Risk of cholelithiasis and cholecystitis may be increased Hypersensitivity reactions: Including anaphylaxis and angioedema have been reported Not recommended: In patients with severe gastrointestinal disease, including severe gastroparesis Additional important counseling points: Pregnancy: Zepbound should not be used for weight management during pregnancy