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More frequent monitoring may be needed with oral semaglutide due to the known pharmacokinetic interaction that increases levothyroxine exposure by approximately 33%

GLP1 receptor internalisation and endosomal signalling GLP1 receptor undergoes rapid agonistmediated internalisation (Widmann et al., 1995)

Overall, while pharmacovigilance reports have described a range of psychiatric symptoms, real-world evidence to date does not support an increased risk of suicidality with GLP-1 RAs in patients with type 2 diabetes