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High-risk groups include older adults, vegans, individuals with pernicious anaemia, those with malabsorption conditions such as Crohn's disease or coeliac disease, people taking metformin or proton pump inhibitors long-term, and those with recent nitrous oxide exposure including recreational use

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[10] Below is a list of other potential drug interactions: Amphetamine/dextroamphetamine Alcohol (ethanol) Aspirin Lorazepam Tadalafil Clomiphene CoQ10 (ubiquinone) Rosuvastatin Duloxetine Testosterone DHEA (dehydroepiandrosterone) Apixaban Fish Oil (omega-3 polyunsaturated fatty acids) Fish Oil Ultra (omega-3 polyunsaturated fatty acids) Flomax (tamsulosin) HCG (chorionic gonadotropin) L-Arginine (arginine) L-Carnitine (levocarnitine) Escitalopram Eszopiclone Quetiapine Levothyroxine Acetaminophen Valacyclovir Cyanocobalamin Ascorbic acid Cholecalciferol Lisdexamfetamine Bupropion Cetirizine Insulin [15] Pregnancy Sermorelin is classified under *Pregnancy Category C* based on animal studies

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