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This versatility stems from the complex network of intracellular signaling pathways triggered by GLP-1R activation
Important safety considerations include a boxed warning for medullary thyroid carcinoma risk (contraindicated in patients with MEN2 or family history of MTC), pancreatitis risk, gallbladder disease, and potential for dehydration
Moreover, the co-administration of gliptins with ACE-inhibitors or angiotensin receptor blockers maybe associated with severe angioedema [148, 149], despite favorable metabolic effects in an experimental model [74]
We therefore suggest monitoring drug levels at least at the start of cotreatment with GLP1RAs, especially in patients with kidney dysfunction who are at risk for drug accumulation to toxic levels
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