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Patients begin with a comprehensive evaluation, including blood pressure, heart rate, eating patterns, sleep quality, and assessment of any contraindications such as uncontrolled hypertension or advanced cardiovascular disease

Alternative approaches to consider before combining medications Before taking the step of adding phentermine to tirzepatide, consider whether any of these evidence-based alternatives might address your plateau or treatment goals without the added risk of combination therapy

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Sanitize the vials Wipe the rubber stoppers of both the peptide vial and the BAC water vial with alcohol swabs

Histamine Nutrients, if needed