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They discuss a case of pulmonary air embolism, RV failure, and cardiac arrest secondary to an ocular venous air embolism

Other notable adverse effects include: Injection site reactions such as erythema, pruritus, or swelling Fatigue reported in approximately 5% to 6% of patients Hypoglycemia when used in combination with insulin or sulfonylureas Increased heart rate with modest elevations of 2 to 4 beats per minute (a class effect of incretin therapies with uncertain clinical significance) Serious but rare adverse effects include acute pancreatitis, gallbladder disease (cholelithiasis, cholecystitis), acute kidney injury (typically secondary to dehydration from gastrointestinal symptoms), and hypersensitivity reactions

However, there is an important interaction to be aware of: Rybelsus can increase total thyroxine (T4) exposure by approximately 33% according to the UK product information

Compounded drops may appear cheaper up front, but inconsistent dosing and potential safety risks make them a gamble