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Examination of bronchoalveolar lavage (BAL) fluid cells and supernatants from allergic asthmatics has revealed the existence of Th2-like cytokine patterns (4,5) together with the IgE elevation (6)

(39), the Bliss synergy score was defined as follows for reduced drug combinations: According to the Bliss criterion, when two independent drugs are combined, their effects simply add up, and the Bliss synergy score is zero

[8] [9] L-carnitine is generally well-tolerated but there are limited reports suggesting it might affect anticoagulant therapy such as warfarin, which would require closer INR monitoring

They are problems with how the molecule is asked to perform a job it cannot do under topical-only conditions