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The combination with niacinamide lacks clinical validation for its safety, stability, or long-term effectiveness

In addition to the results from SURPASS 4, which was designed to provide preliminary evidence for the cardiovascular safety of tirzepatide, a separate analysis pooling all the clinical trials with tirzepatide was used to generate a pre-specified estimate of cardiovascular events [20] (Table 1)

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If dizziness prevents safe dose escalation, your provider may recommend a slower titration schedule, dose reduction, or a different peptide compound better suited to your individual tolerance profile