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It has less nausea than tirzepatide, but again the vomiting and diarrhea are noticeably worse

Endosome-mediated uptake might also be involved (27)

Studies in cultured hepatocytes and in vivo

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Patients should also be aware that certain medicationssuch as proton pump inhibitors (PPIs) and metformincan interfere with B12 absorption, though this is less relevant once on injection therapy