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Cosmos Study December 16, 2025 Dual-Team Study Team A:Kersten Bartelt, RNNicholas Volker Team B:Tony Dunnigan, MDEric Barkley Key Findings Among patients with type 2 diabetes, GLP-1 use was associated with a 32% lower fracture risk for those with either osteopenia or osteoporosis

Standard dosing protocols Beginner dose (first 2-3 uses): 1mg (1000mcg) per dose Single spray per nostril (0.5mg each) OR full 1mg in one nostril 30-60 minutes before anticipated sexual activity Assess tolerance and effectiveness Standard dose (most men): 1.5mg (1500mcg) per dose Effective for 70-80% of men 45-60 minutes before sex Use 1-2 times weekly maximum Maximum dose: 2mg (2000mcg) per dose Only if 1-1.5mg insufficient Do NOT exceed 2mg Higher doses = more side effects, not necessarily better results Frequency limits: Maximum 2-3 doses per week Allow 48-72 hours between doses Don't use daily (tolerance and side effects) How to administer PT-141 nasal spray Step-by-step administration: Prepare spray: Remove cap from nasal spray bottle If first use, prime by spraying once into air Hold upright Position: Tilt head slightly forward (NOT back) Close one nostril with finger Insert spray tip into open nostril Spray: Spray once while inhaling gently through nose Remove spray tip Breathe gently through nose to distribute Repeat if needed: Switch nostrils for second spray if dosing 1mg+ total Don't spray more than recommended dose After administration: Avoid blowing nose for 15-30 minutes Sit or stand for a few minutes Wait 30-60 minutes before sexual activity Storage: Refrigerate nasal spray (2-8C) Protect from light Use within 30 days of opening Check expiration date See our peptide storage guide for detailed storage info