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Use caution when topiramate is prescribed with other drugs that predispose patients to heat-related disorders, such as drugs with anticholinergic activity, carbonic anhydrase inhibitors, and zonisamide
But here is the critical distinction
Why Ipamorelin avoids cortisol and prolactin spillover Ipamorelin is a selective GHS-R1a agonist that produced GH release comparable to GHRP-6 in rats without measurable elevation of ACTH, cortisol or prolactin at GH-releasing doses (Raun et al., 1998)
Because of the increased risk of adverse reactions, it is not recommended for use in the absence of diabetes
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