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The GI societies also noted the impact of stopping this medication prior to upper gastrointestinal endoscopy or other moderate to deep sedated procedures is unknown at this time. As clinical gastroenterologists and hepatologists, we are very familiar with safety issues regarding the performance of endoscopy in our patients suffering from gastroparesis, as well as unexplained nausea, vomiting and epigastric pain, particularly in emergency situations, the GI societies wrote

Degradation During Lyophilization Some peptides can degrade during the freeze-drying process