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It had limited food-supplement GRAS history in some jurisdictions but Australia's TGA placed it on Schedule 4 (prescription) in 2020

NHS availability would require successful Phase 3 trials, marketing authorisation, and a positive NICE health technology appraisal

Additional concerns surround DPP-4 inhibitors and their interference with immune function

use requires close monitoring for hematologic toxicities and the drug should not be used with patients who have a glucose-6-phosphate dehydrogenase deficiency

The lens inside your eye can swell or shrink slightly as glucose levels change, temporarily affecting your focus