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2023 Jul 8;24(14):11236
Important considerations before combining these medications include: Absolute contraindications : The combination should be avoided in patients with cardiovascular disease, uncontrolled hypertension, hyperthyroidism, glaucoma, during or within 14 days of MAOI use, personal/family history of MTC or MEN2, pregnancy, breastfeeding, or severe gastrointestinal disease Cardiovascular risk assessment : Phentermine increases heart rate and blood pressure, which requires careful monitoring with baseline and follow-up measurements of vital signs and possibly EKG if cardiac history exists Gastrointestinal tolerability : Tirzepatide commonly causes nausea, vomiting, and diarrhea, which may be compounded by phentermine's effects Medication interactions : Tirzepatide may reduce the effectiveness of oral contraceptives during initiation and dose escalation
Higher concentrations can actually improve stability in some cases because the peptide molecules essentially buffer each other, but they also create more opportunity for aggregation under heat stress
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