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Patients should discuss risks carefully if they have: A history of pancreatitis Severe nausea, vomiting, or gastroparesis Gallbladder disease Severe dehydration risk Advanced kidney disease with frequent vomiting or poor oral intake A personal or family history of medullary thyroid cancer Multiple endocrine neoplasia syndrome type 2 Pregnancy, plans for pregnancy, or breastfeeding Also, if you have active lupus nephritis or unstable lupus, your rheumatologist and nephrologist should be involved before starting any new medicine that could affect hydration, nutrition, kidney function, or medication tolerance