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Co-administration of topiramate with diltiazem hydrochloride extended-release resulted in a 16% increase in C max and a 19% increase in AUC 12 of topiramate
Alternatives and Add-Ons Ipamorelin is the modern GHRP choice when tesamorelin is unavailable or when a GH-pulse amplifier is needed see the GH secretagogue comparison
A couple of things Ive noticed with GLP-1: Tirzepatide seems to be tolerated better get them on fiber supplementation and treat any underlying GERD or constipation make sure they arent overeating on their injection day I would use the minimal dose that is able to achieve weight loss with minimal to no side effects
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