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plenty of compounds look benign in animals and later show unexpected human toxicities (cardiac, hepatic, immunologic, etc.)

Shaking the vial can cause the delicate peptide chains in tirzepatide to break apart or denature. This may make the medication less effective or completely inactive

In contrast, blood glucose level of 54 mg/dL or less occurred in 6% of patients receiving the 14 mg tablets, 3% of patients receiving placebo, and 0% of patients receiving the 7 mg tablets

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Turkovic et al., 2004)