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The primary concern is cardiovascular stress: phentermine raises heart rate and blood pressure, while adding a GLP-1 receptor agonist can cause additional hemodynamic changes and increase the risk of arrhythmias or myocardial complications in susceptible individuals
By blocking NNMT activity, it increases critical cellular metabolites (SAM, NAD) that drive downstream increases in energy expenditure and metabolic health 1-4
The result is improvement in both fasting and post-meal blood sugar levels
In a trial where patients switched from subcutaneous tirzepatide to oral orforglipron, they regained an average of 5 kg previously lost
One of several amino acids needed to support liver function
Appetite typically increases within 12 weeks of discontinuation, with full return to baseline hunger signals within 48 weeks
