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Commonly reported issues include: Mild irritation or redness at the injection site Headaches Fatigue Nausea These effects tend to resolve quickly and do not usually require medical intervention
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
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Acknowledgements The authors are thankful to the School of Medicine, Jeffrey Cheah School of Medicine and Health Sciences, and Monash University Malaysia
As sleep disturbances become more prevalent in modern society, understanding and utilizing compounds like DSIP can pave the way for effective solutions to achieve restorative sleep
