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non-oral contraceptive methods should be considered [1] Optimization strategy : Tirzepatide monotherapy should be optimized to the maximally tolerated dose with confirmed adherence before considering phentermine addition Cost considerations : Both medications can be expensive, particularly tirzepatide, which may limit accessibility Any decision to combine these medications should involve shared decision-making with written informed consent, thorough evaluation of the patient's medical history, current health status, weight loss goals, and potential contraindications

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