The heartburn comes from acid reaching the esophagus through a mechanical process (delayed emptying plus increased pressure), not from any toxic or erosive effect on stomach tissue
Generally speaking, if you store it correctly and it remains unopened, the loss of potency over the course of 120 days is extremely smallwere talking 1-2% at most
For constipation, osmotic laxatives like polyethylene glycol are generally preferred
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The STEP 5 data suggests that ongoing administration is necessary to maintain results, as participants who discontinued semaglutide in the STEP 1 extension study regained approximately two-thirds of the weight they had lost within one year of stopping