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Transdermal delivery systems bypassing first-pass metabolism while avoiding injection requirements could improve patient acceptance, though the relatively large molecular size of T4 presents challenges for passive skin penetration that would require enabling technologies such as microneedles or chemical penetration enhancers

The main risks include gastrointestinal side effects (nausea, vomiting, diarrhoea), increased risk of nutritional deficiencies due to combined appetite suppression and reduced stomach capacity, and potential hypoglycaemia in patients taking certain diabetes medications