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200-400mg standardized extract (≥25% gymnemic acids) 1-2x daily, or 2-4g dried leaf

With meals · with food (preferred)

Standardized extract (≥25% gymnemic acids)

Investigational / China-only dosing: once-weekly subcutaneous injection, dose-escalated over several weeks. Trial maintenance doses studied were 4 mg, 6 mg, and 9 mg once weekly (lower doses used during titration to limit GI effects). There is no FDA-approved regimen.

Any time

Once-weekly subcutaneous injection (investigational; China-approved as Xinermei)

• Use of insulin or sulfonylureas without medical supervision (hypoglycemia risk)

• Diabetes medications (insulin, sulfonylureas, metformin)

• Pregnancy and breastfeeding
• Personal or family history of medullary thyroid carcinoma or MEN2 (class-level precaution for GLP-1-based agents)
• History of pancreatitis (use with caution / avoid)

• Insulin and sulfonylureas
• Oral medications generally