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Cases of remitting seronegative symmetrical synovitis with pitting edema syndrome, presenting as symmetrical synovitis with dorsal hand and foot edema, have also been reported in individuals receiving DPP-4 inhibitors [13, 34]

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By day 4 after a missed dose, drug levels have dropped enough that adding a late dose on top of what remains could create unpredictable effects

the efficacy of this approach has been demonstrated in available studies (low-dose statin + nutraceutical, nutraceutical + ezetimibe) [135] (Figure 5)

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No study examined tolerance or dependence with extended use, and no study followed a repeated-dosing cohort beyond a few months