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Following addition of the -hydroxyl the fatty acid is a substrate for an alcohol dehydrogenase (ADH) which generates an oxo-fatty acid, followed by generation of the corresponding dicarboxylic acid via the action of an aldehyde dehydrogenase (ALDH) family member enzyme
Zepbound (tirzepatide) [prescribing information]
10.1007/s12020-019-01891-3 93 SmitsM
The good news: it is dose-dependent, peaks during escalation, and typically resolves within 8-12 weeks
Restarting at a lower dose and re-titrating up over several weeks is the safer approach
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