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[145] [150] [151] The most important transcription factors [note 12] that produce these alterations are Delta FBJ murine osteosarcoma viral oncogene homolog B (FosB), cAMP response element binding protein (CREB), and nuclear factor-kappa B (NF-B)

In such cases: Use backup contraception during prolonged gastrointestinal upset Consider switching to a non-oral method if symptoms persist Should I switch to a different contraceptive

Evidence shows that B6 plays a vital role in maintaining normal sperm parameters

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Key monitoring points include: Serum creatinine and eGFR at baseline Repeat testing if gastrointestinal symptoms are severe or persistent Regular review in patients with eGFR 6 hours Patients should contact NHS 111 if they are unable to maintain hydration or have signs suggesting AKI

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