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Exclusion criteria included the presence of comorbid conditions likely to influence hemorrhoidal disease or treatment outcomes (e.g., inflammatory bowel disease, chronic liver disease), recurrent hemorrhoids, concomitant anorectal disorders such as fissures, fistulas, or abscesses, and current use of medications known to interfere with MPFF efficacy or safety

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It also generates foam that makes it impossible to verify whether the powder has fully dissolved

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If symptoms persist beyond three weeks or become severe, your provider may recommend a temporary dose adjustment, switching to oral tirzepatide, or exploring alternative PlexusDx formulations such as semaglutide-only or GLP-Squared compounds