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10.1016/S0140-6736(84)92209-8 Stumpf DA, Parker WD, Haas R: Carnitine deficiency with valproate therapy
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neither pathway affected by semaglutide Clinical trial evidence / STEP trials permitted concomitant PPI use with no reported increase in adverse events Absorption concern / Delayed gastric emptying may slow PPI peak plasma concentration (Tmax) without reducing total bioavailability (AUC) GI overlap / Both drug classes affect gastric physiology
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In contrast, GLP-1 receptor agonists are particularly effective in reducing major adverse cardiovascular events, while their effect on HF hospitalization appears more modest, with relative risk reductions of approximately 11% (HR 0.89) in pooled analyses [6, 14]
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