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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

By targeting both GLP-1 and GIP receptors, it helps regulate blood sugar while promoting significant weight loss

Australian-Sourced BAC Water Bacteriostatic Water for Peptide Research Sterile bacteriostatic water (10mL) containing 0.9% benzyl alcohol, commonly used for peptide reconstitution and laboratory research applications requiring bacteriostatic preservation

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

Tirzepatide initiation was actually associated with a lower overall risk of joint pain, including lower back pain, hip pain, and knee pain

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