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Some individuals may experience: Mild injection site irritation or warmth Temporary flushing or tingling Nausea or lightheadedness Rare headache or fatigue Most side effects are mild and transient

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Key considerations include: Pre-existing mental health conditions may be exacerbated during weight loss Physiological changes accompanying weight loss may affect emotional stability Medication effects on gastric emptying may reduce absorption of oral medications, including oral contraceptives (requiring backup contraception after initiation and dose increases) Social and lifestyle changes during treatment create psychological stressors Clinicians should maintain awareness that mood changes during Zepbound therapy likely represent multifactorial phenomena rather than simple cause-and-effect relationships

In 2024, FDA issued warning letters to companies including Prime Peptides, Summit Research Peptides, SwissChems, Xcel Research, and Veronvy for marketing unapproved new drugs for human use

doi: 10.1016/j.dci.2015.10.018 62 HillyerJFStrandMR