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N-Hydroxysuccinimide (NHS) Conjugation Some ADCs utilize N-hydroxysuccinimide (NHS) esters to react with lysine (Lys) residues on the antibody, forming stable amide bonds (Figure 9)

Most physicians recommend introducing one compound before the other rather than starting both simultaneously

doi: 10.1016/j.fitote.2009.11.001 257

Sleepiness has been reported in about 6% to 13% of users, and fatigue in about 5% to 8% , depending on the study population and indication, according to this review on Lexapro tiredness and side effects