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risk is low with Ozempic alone Fatigue and dizziness : reported by some patients Rare but serious effects : pancreatitis, gallbladder disease, and potential thyroid effects (thyroid C-cell tumours have been observed in animal studies, though human relevance remains uncertain) Common side effects of Topamax include: Cognitive and psychiatric effects : difficulty concentrating, memory problems, confusion, mood changes, and depression Paraesthesia : tingling sensations, particularly in the hands and feet Taste alterations : particularly affecting carbonated beverages Weight loss and decreased appetite Metabolic acidosis : due to carbonic anhydrase inhibition Kidney stones : increased risk, particularly with inadequate hydration Visual disturbances : acute myopia and secondary angle-closure glaucoma (rare but serious) When combining these medications, particular attention should be paid to: Cumulative gastrointestinal effects : The combination may lead to more pronounced nausea, vomiting, or diarrhoea, potentially causing dehydration and electrolyte imbalance Dehydration risk : Both medications can contribute to fluid lossOzempic through gastrointestinal effects and Topamax through reduced fluid intake (due to taste changes) and increased kidney stone risk

These treatments should thus be prioritized for patients with T2D at risk for the development of NAFLD/NASH (e.g., obesity)

However, a recent report demonstrated that large doses of exogenous iron (200 mg) and ascorbic acid (75 mg) promoted the release of iron from iron binding proteins and also enhanced in vitro lipid peroxidation in serum of guinea pigs

Furthermore, both evolved proteases initiated cell death when reconstituted with BoNTs H N domain, enabling self-delivery into cancer cells