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The regulation of COX2 expression is complex, involving transcriptional and post-transcriptional mechanisms influenced by cytokines, growth factors, and pro-inflammatory stimuli (225)

Abdominal Cramping: The combination of slower stomach emptying (from tirzepatide) and altered sugar absorption (from metformin) can lead to temporary discomfort

Licensed alternatives for weight management, including semaglutide (Wegovy) and liraglutide (Saxenda), are available through regulated NHS and private pathways following NICE appraisal

Individual variation: Results differ greatly from person to person

doi: 10.13201/j.issn.1001-1439.2024.04.001 14

Chapman, E