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While tirzepatide is not primarily eliminated through the kidneys, the gastrointestinal effects of the medication, including potential nausea, vomiting, and diarrhea, could lead to dehydration and electrolyte imbalances that may be particularly problematic in patients with compromised kidney function

One thing to know is that all of these prescriptions are equally effective

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However, if the imbalance persists (such as with continued bleeding as can happen in HHT), over time the iron stores become exhausted resulting in iron deficiency anemia