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[10] Additive depressant effects occur with other class I antiarrhythmics, phenytoin, and volatile anesthetics, while epinephrine-containing local formulations may potentiate vasoconstriction and delay systemic absorption-beneficial for prolonging local anesthesia but hazardous if inadvertent intravascular injection occurs

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Success requires physician supervision, objective body composition monitoring (not just scale weight), and integration with proper nutrition and exercise foundations for optimal metabolic outcomes