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If the patients has avoided using the limb due to pain, there may be a loss of muscle bulk due to disuse atrophy

Naunyn-Schmiedeberg's Arch Pharmacol 398 , 1635516384 (2025)

By combining the other ingredients, we see a synergistic (combined) benefit that seems to support functions such as cell energy production, increased antioxidant capacity, preservation of cell membrane, compensating for oxidative stress, and so on, reduce inflammation and even increase nitric oxide levels

While the linker does not contain a protease-sensitive moiety, it does contain an acid-sensitive carbonate formed with the C-20 hydroxyl group of SN-38