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The decision to combine these medications should never be made without medical supervision, and patients should not initiate orlistat (even the over-the-counter formulation) while taking tirzepatide without discussing it with their healthcare provider

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268 Inflammatory cytokines (e.g., IL-6 and TNF-) upregulate the expression of CYP24A1 in colon cancer cells by activating the NF-B pathway, which in turn leads to abnormal activation of the Wnt/-catenin pathway and promotes disease progression

Although PPIs exhibit exceptional acid inhibition effects, various studies have linked PPI use with adverse digestive events, such as small intestinal bacterial overgrowth (SIBO) and Clostridium difficile infection