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It exists to protect sterility, effectiveness, and ultimately, patient safety

Medication Interactions (Do This Before You Buy It) Berberine can interact with medications, including through effects on drug-metabolizing enzymes (notably CYP3A4 and CYP2D6) and transport proteins

These include mitigation of hyperglycemia, overweight and insulin resistance, systemic and glomerular hypertension, dyslipidemia, sodium retention, inflammation and renal hypoxia

and I think this is a big emerging DDI between PPIs and GLP-1 drugs that needs to be studied more

For best results, use consistently alongside training and a balanced diet