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Trends Endocrinol Metab 31:410421 Sassin AM, Sangi-Haghpeykar H, Aagaard KM, Detti L (2023) Effects of metformin alone versus metformin and tirzepatide on weight loss in patients with polycystic ovarian syndrome (PCOS)

[5] [17] Symptoms of hypoglycemiaincluding confusion, excessive sweating, tremor, rapid heartbeat, or loss of consciousnessrequire immediate intervention, especially in patients taking concurrent insulin or sulfonylureas

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The rationale is that pulsed dosing every 4 days may be sufficient to trigger the downstream regulatory cascades, since epithalons effects are thought to outlast the peptides actual plasma residence

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