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Close monitoring for symptoms of low blood sugar (headache, dizziness, sweating, shaking) is essential, and strategies for managing hypoglycemia, such as consuming 15 grams of carbohydrates, should be discussed
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However, in October 2023, Pfizer discontinued its other oral GLP-1 candidate, lotiglipron, due to elevated liver enzymes observed in clinical trials
Renal Elimination: Sitagliptin is not extensively metabolized by the liver enzymes cytochrome P450 3A4 and 2C8

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