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The ulcers develop from a combination of factors, including decreased blood flow to the mucosa causing ischemia and hypoperfusion-reperfusion injury

compared with DPP-4 inhibitors, the risk was 68% higher

Whether compounded formulations with niacinamide achieve equivalent or superior absorption is unknown

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However, the delayed gastric emptying effect may affect the absorption of some oral medications, which may need to be considered for certain drugs with narrow therapeutic windows