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The bio-availability of the DPP-4 inhibitors is very good and the pharmacodynamic- as well as the pharmacokinetic characteristics lead to the above mentioned clinically sufficient DPP-4 inhibition with once daily dosing (only vildagliptin has to be dosed twice daily) (18, 19)

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If the internal case temperature is still below 77 degrees Fahrenheit and you are within a few hours of reaching a refrigerator, your medication is likely fine

In contrast, two studies, including 41,046 exposed pregnancies and 131,407 comparator pregnancies, identified a statistically significant association with urinary congenital malformations (OR 1.24