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According to the manufacturers instructions, Ozempic should be refrigerated between 36F and 46F (2C and 8C) before its initial use

Clinicians should maintain a high index of suspicion for alternative diagnoses and investigate appropriately when patients report persistent or severe upper gastrointestinal symptoms

Blood cancers including chronic lymphocytic leukemia, lymphoma, and acute lymphoblastic leukemia cause persistently high counts often exceeding 10,000-20,000 cells per microliter, unlike temporary infection-related spikes