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190 In general, cyanopyrrolidines such as saxagliptin are competitive inhibitors rather than noncompetitive inhibitors of DPP-IV enzymatic activity since they form reversible covalent bonds with serine residue 630 located within the enzyme's active site

Mechanick JI, Apovian C, Brethauer S, Timothy Garvey W, Joffe AM, Kim J et al

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We recently encountered a similar case at our institution - a 49-year-old woman with type 2 diabetes, obesity, and chronic pain on long-term narcotic therapy, who presented with abdominal distension and vomiting after two years of tirzepatide (Mounjaro) therapy

Available from: MacDonald, P

PMID: 10067836