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However, conditions affecting the gastrointestinal tractincluding pernicious anaemia, Crohn's disease, coeliac disease, or gastric surgerycan significantly impair absorption, necessitating alternative supplementation routes such as intramuscular hydroxocobalamin injections, which deliver B12 directly into the bloodstream

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The Increlex label explicitly contraindicates use in patients with active or suspected neoplasia and notes that active or suspected malignancy should prompt discontinuation

Fasted administration is critical because the peptide works by stimulating lipolysis (fat breakdown) through beta-3 adrenergic receptor activation

GLP-1 receptor agonists are generally discontinued before planned conception according to labeling, and phentermine-topiramate has specific fetal toxicity risk because of topiramate-associated oral clefts