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No dosage adjustment is needed for patients with renal impairment, though renal function should be monitored in patients experiencing severe adverse gastrointestinal reactions

Another study in colonic-sensitized rat models demonstrated that exendin-4 treatment dose-dependently reduced visceral hypersensitivity by upregulating serotonin transporter (SERT) expression and downregulating tryptophan hydroxylase-1 (TPH-1) expression [57]

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