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Alternatively, the court could affirm the FDA position, further restricting compounding operations

These medications may interact with nitrates, certain blood pressure medications, alpha-blockers, alcohol, and other PDE-5 therapies - and some of those interactions can cause significant drops in blood pressure

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These include: Lifestyle interventions (dietary advice, physical activity programmes) Licensed pharmacotherapy such as orlistat, or GLP-1 receptor agonists including semaglutide 2.4 mg (Wegovy, NICE TA875) or tirzepatide (Zepbound) where clinically indicated and available Referral to tier 3 or tier 4 weight management services , including bariatric surgery assessment where appropriate Information on NHS weight management services and eligibility for licensed treatments is available via the NHS website and NICE guidance