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The metabolic effects of these compounds become more apparent when you have experienced both

Researchers who have never used a GLP-1 agonist should generally start with tirzepatide or even semaglutide to understand their individual response to incretin therapy before attempting a triple agonist with higher side effect rates

Low blood sugar (hypoglycemia): More likely if combined with insulin or sulfonylureas

doi: 10.1093/qjmed/hcx152 [DOI] [PubMed] [Google Scholar] 4

This is part of why understanding how peptides work at the receptor level gives you a more nuanced perspective on timing
