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[9] A related cause is reduced stomach acid production with age or from long-term use of proton-pump inhibitors, [10] H 2 blockers, or other antacids, [11] and interaction with metformin

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The absence of liver toxicity with orforglipron, despite its primary route of elimination through hepatic CYP3A-mediated metabolism, suggests that the hepatotoxicity observed with danuglipron and lotiglipron was related to the specific chemical structures of those molecules rather than to the class of small-molecule GLP-1 agonists as a whole