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This is partly what causes muscular weakness and lethargy in pets with Graves Disease

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The levocarnitine component does not create any unique interaction with alcohol, but the general guidance for alcohol and tirzepatide applies: moderation at most, and awareness that tolerance may change significantly while on GLP-1 therapy

[10] Gastrointestinal disturbances-including nausea, loose stools, and a transient fishy body-odor attributable to trimethylamine production from excessive carnitine and choline metabolism-occur in a minority of recipients and are usually self-limiting within 24 to 48 hours after injection