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State Medicaid programs, already facing budget constraints, often prioritize diabetes indication over weight management, even though both represent FDA-approved uses with clinical evidence

Avoid combining with NSAIDs, which may counteract its healing effects

The anti-itch combination protocol: Layer 1: Oral antihistamine (cetirizine 10mg in the morning) Layer 2: Topical hydrocortisone 1% applied to affected area twice daily Layer 3: Cold compress for breakthrough itch (10 minutes as needed) Layer 4: Diphenhydramine 25mg at bedtime if itch disrupts sleep Avoid scratching at all costs