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Contact your healthcare provider if you experience: Persistent constipation lasting more than three days despite dietary modifications and adequate hydration Severe or persistent diarrhea (more than six loose stools daily or lasting beyond 48 hours) Rectal bleeding, even if minor, particularly if bright red blood is noted on toilet paper or in the toilet bowl Black, tarry, or maroon-colored stools (which may indicate bleeding higher in the digestive tract) Severe abdominal pain, cramping, or bloating that interferes with daily activities Signs of dehydration including dark urine, dizziness, or decreased urination Painful bowel movements or a sensation of incomplete evacuation Visible or palpable lumps around the anus Persistent anal pain, itching, or discomfort Seek immediate medical attention for: Severe, persistent abdominal pain, especially if radiating to the back (may indicate pancreatitis) Right upper quadrant pain, fever, or yellowing of skin/eyes (may indicate gallbladder disease) Heavy rectal bleeding or passage of large amounts of blood Severe abdominal pain with fever, persistent vomiting, abdominal distension, and inability to pass stool or gas (may suggest bowel obstruction) Signs of severe dehydration including confusion, rapid heartbeat, or inability to keep fluids down Important: If you suspect pancreatitis (severe abdominal pain, often radiating to the back, with or without vomiting), stop taking Zepbound immediately and seek urgent medical care

Tumor-associated macrophages (TAMs), important immunosuppressive cells in the microenvironment, are able to activate the Gli2/IGF-2/ERK1/2 signaling axis to promote TGF- secretion and thus mediate the migration, invasion and EMT of hepatocellular carcinoma cells (Huh-7 cells) (73)

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Hou Z, Lambert JD, Chin KV, Yang CS (2004) Effects of tea polyphenols on signal transduction pathways related to cancer chemoprevention

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