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[19] Because topiramate is a carbonic anhydrase inhibitor, clinically important adverse effects may include metabolic acidosis, hypokalemia, nephrolithiasis, cognitive slowing, paresthesias, mood symptoms, and ocular adverse effects

It sits between the skin and muscle

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By the rational design of the biparatopic VNAR-D1 and C4, we improved this stabilization, resulting in several orders of magnitude enhancement in neutralizing potency and binding affinity 25

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Autoimmun Rev (2010) 9:A2716