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Absolute Contraindications: Personal or family history of medullary thyroid carcinoma (MTC) Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) Previous serious hypersensitivity to semaglutide or formulation components Pregnancy (discontinue at least 2 months before planned conception) Breastfeeding (insufficient data on excretion in human milk) Relative Contraindications (Use with Caution and Medical Supervision): History of pancreatitis (potential risk factor) Severe gastrointestinal disease including gastroparesis Diabetic retinopathy (requires ophthalmologic monitoring) Severe kidney disease (limited data in advanced renal impairment) History of suicidal ideation or severe depression (monitor mental health) Gallbladder disease or history of cholecystitis Age under 18 (pediatric safety not established for most formulations) How Semaglutide Side Effects Compare to Similar Peptides Understanding how semaglutide’s side effect profile compares to other weight management and metabolic peptides helps inform treatment selection

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If the number of sperm per milliliter is less than 15 million or the number of sperm per ejaculation is less than 39 million, the probability of fertility is reduced