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Even in cases where outsourcing facilities produce these drugs, there are nagging questions about how pharmacies can obtain large volumes of the same active ingredients used in the brand drugs, raising concerns about the quality of compounded versions

Serious adverse events are less common but documented: pancreatitis, gallbladder disease, hypoglycemia (particularly in patients on concomitant diabetes medications), and a boxed warning regarding medullary thyroid carcinoma risk in rodent studies - a finding whose clinical significance in humans at therapeutic doses remains under study

Initial results reported that phase I metabolism of the nootropic was very low with an intrinsic clearance of 2.72 ul/min/mg, as well as an average half life of approximately 510 minutes

Brambilla P, Hardan A, di Nemi SU, Perez J, Soares JC, Barale F

Robert Kushner, professor of medicine at Northwestern University Feinberg School of Medicine and one of the country's leading obesity medicine specialists