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Gastrointestinal issues are among the most common side effects, with nausea occurring in 15-20% of users, vomiting in 5-9%, and diarrhea in 8% of patients [2]

Metformin may be continued in some indications under specialist care, but berberine should be avoided due to insufficient safety data

This helps to optimize its effectiveness

However, the risk of cholelithiasis, micronutrient deficiencies and lean muscle mass loss during the rapid WL phase are of particular concern with the new obesity treatments

It also does not appear to cause clinically significant interactions with chemotherapy agents when used as part of a breast cancer treatment regimen (as often endocrine therapy is given sequentially or concurrently with other treatments in practice without issue)