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The question of whether these agents can be safely used together requires careful consideration of pharmacological properties, clinical evidence, and FDA guidance regarding thyroid-related safety concerns specific to GLP-1 receptor agonists

On one hand, DPP4 degrades incretins such as GLP-1 and GIP, ultimately leading to reduced insulin secretion and abnormal visceral adipose tissue metabolism

The Euro Heart Survey found that, among 1,425 patients with known diabetes and CAD, the combination of aspirin, a beta-blocker, a renin-angiotensin-aldosterone system (RAAS) blocker, and a statin was associated with a significantly lower all-cause mortality (3.5 vs 7.7%

Gerstein HC, Li Z, Ramasundarahettige C, Baek S, Branch KR, Del Prato S, et al

If you notice coughing, open-mouth breathing, fainting, or sudden exercise intolerance, treat it as urgent and seek veterinary care promptly

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