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The concern is cumulative time outside refrigeration

Given what we do understand about the potential action on cellular signaling pathways this could pose serious risk

This benefits people with low stomach acid (including many people over the age of 50) or those who take acid blockers such as Pepcid or Zantac, or proton pump inhibitors such as Prevacid, or Prilosec, who are at an increased risk for B-12 deficiency

Published steady-state exposure puts 14 mg oral daily closer to a 0.5 mg weekly injection, and even 25 mg oral daily lands near a 0.9 mg weekly injection short of Wegovy 2.4 mg. Switching routes is an exposure change, not a brand swap