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Safety monitoring is essential, including assessment for hypoglycaemia risk, diabetic ketoacidosis, gastrointestinal effects, renal function, and pancreatitis

Common Causes of Peptide Impurities Solid-phase peptide synthesis errors Incomplete deprotection reactions Amino acid racemization Aggregation and degradation Regulatory guidelines usually require identification of impurities present at 0.10% relative abundance in peptide drug substances

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Oral NAD+ supplements must pass through the digestive system, where absorption is significantly limited (often less than 15%)