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Clinical trial data and FDA labeling information indicate that gastrointestinal effects are dose-dependent and typically most pronounced during initial treatment or dose escalation

It enhances insulin secretion, inhibits glucagon release, and slows gastric emptying, all of which help to regulate blood sugar

Taking topiramate while following a keto diet might compound the problem and increase the risk of acid overload

Dini, I., Alborino, V., Lanzuise, S., Lombardi, N., Marra, R., Balestrieri, A., Ritieni, A., Woo, S.L

While some primary effects, such as a reduced appetite, will continue throughout treatment, symptoms like nausea, diarrhoea, and bloating often become far less noticeable after the first few weeks

Early coordination helps align substitutions, quantity planning, and delivery expectations with real operational capacity