Depending on the dose, the vial will range in cost between $399 to $549, according to The New York Times
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Risk factors for metformin-associated lactic acidosis include renal impairment, concomitant use of certain drugs (e.g., carbonic anhydrase inhibitors such as topiramate), age 65 years old or greater, having a radiological study with contrast, surgery and other procedures, hypoxic states (e.g., acute congestive heart failure), excessive alcohol intake, and hepatic impairment
But over the last few years, large international trials have shown GLP-1 drugs reduce major cardiovascular events such as heart attacks, strokes and heart failure deaths in high-risk patients
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The short half-life of active GLP-1 and GLP-2 of only a few minutes due to rapid degradation by dipeptidyl peptidase-4 (DPP4) 12 suggests a rather dynamic regulation of these proteins