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Acute kidney injury : Though rare, any GLP-1 receptor agonist can potentially cause dehydration (particularly if severe vomiting or diarrhoea occurs), which may precipitate kidney problems

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Generic phentermine-topiramate ER became available in 2025, which has further reduced costs

They influence an entire cascade of hormonal pathways, and understanding these broader effects helps explain why some people struggle more than others during discontinuation

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