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Contact your GP, study team, or supervising clinician if fatigue: Is severe enough to significantly impair daily functioning, work, or personal care Persists without any improvement despite the dose stabilising Is accompanied by dizziness, fainting, or palpitations , which may suggest dehydration or electrolyte disturbance Occurs alongside unexplained weight loss beyond expected levels , pallor, or breathlessness which could indicate nutritional anaemia Is associated with low mood, persistent sadness, or loss of motivation , as these may suggest depression rather than drug-related tiredness Develops alongside jaundice, dark urine, or abdominal pain , which warrant urgent assessment to exclude hepatic or pancreatic causes Seek urgent medical attention (call 999 or go to A&E) if you experience: Severe, persistent upper abdominal pain, particularly if it radiates to the back and is accompanied by vomiting these are potential symptoms of pancreatitis and require immediate assessment [12] Chest pain, severe dizziness, confusion, or an inability to keep any fluids down For urgent advice that does not require emergency services , contact NHS 111 (online at 111.nhs.uk or by telephone)

Multi-organ damage in human dipeptidyl peptidase 4 transgenic mice infected with Middle East respiratory syndrome-coronavirus

Clin Cancer Res 9:57565767 Madiraju P, Pande SV, Prentki M, Madiraju SR (2009) Mitochondrial acetylcarnitine provides acetyl groups for nuclear histone acetylation

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It can also be used to prevent osteoporosis and reduce the risk of heart disease in postmenopausal women