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Drug Interactions The concomitant use of saxagliptin and metformin hydrochloride extended-release tablets with specific drugs may increase the risk of metformin-associated lactic acidosis: those that impair renal function, result in significant hemodynamic change, interfere with acid-base balance or increase metformin accumulation [see Drug Interactions (7)]

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Ipamorelin is a prescription version of a substance naturally produced by your body known as a human growth hormone-releasing hormone or growth hormone-releasing factor (GHRH or GHRF)