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Furthermore, many of these were pharmacovigilance studies, and the outcome of suicidal ideation was inconsistently documented (104)

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Radiolabeled receptor binding assays show oxyntomodulin binds to the GLP-1R with an approximate 10-fold reduction in potency relative to native GLP-1, with a comparative 100-fold reduction in cAMP potency, indicating the extent of oxyntomodulins 8 amino acid C-terminal extension in conferring additional promiscuity at the GLP-1R [41]

Rybelsus carries a boxed warning regarding the risk of thyroid C-cell tumors, based on rodent studies showing dose-dependent and treatment-duration-dependent increases in thyroid C-cell tumors