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### Unique Side Effects by Medication **Semaglutide-specific considerations:** - Longest safety track record - Well-characterized cardiovascular benefits (SELECT trial) - Sulfur burps less commonly reported than with tirzepatide **Tirzepatide-specific considerations:** - Sulfur burps more frequently reported by patients - Slightly different GI symptom pattern due to GIP component - Growing real-world safety data alongside clinical trial data **Retatrutide-specific considerations:** - **Heart rate increase** — glucagon receptor activation can modestly increase heart rate (2-5 bpm average in Phase 2)

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