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Stacked Protocol (Cagrilintide + Smglutd) Dose: 0.6 2.4 mg Cagrilintide + 0.25 2.4 mg Smglutd (= 2496 clicks) Duration: 12 20 weeks Frequency: Once weekly, co-administered Cycle Interval: 4 6 weeks off before repeating Goal / Description: Dual amylin and GLP-1 receptor activation studied for enhanced metabolic and weight outcomes

A rechallenge with topiramate 3 months later again resulted in epistaxis requiring 2 units of packed blood cells

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