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Serious adverse events are less common but documented: pancreatitis, gallbladder disease, hypoglycemia (particularly in patients on concomitant diabetes medications), and a boxed warning regarding medullary thyroid carcinoma risk in rodent studies - a finding whose clinical significance in humans at therapeutic doses remains under study

1A and S1B), time at which the percentage of activated POMC neurons was reduced (Fig

New England Journal of Medicine 2017

Thus, oral administration of a peptide therapeutic represents a significant advance in medicine, but is challenged by gastrointestinal instability and ineffective uptake into the circulation