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The gap goes back to how Part D (the part of Medicare that covers medication) was written when drug coverage began in 2006

Monitoring protocols : Establish a clear monitoring schedule including regular weight checks, vital signs (blood pressure and heart rate after each stimulant dose change and at least every 6 months), assessment of ADHD symptoms, evaluation of eating patterns and nutritional adequacy, and screening for adverse effects from either medication

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It also includes creatine, which is commonly recommended to help counteract muscle loss in individuals using GLP-1 medications