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During its catalytic cycle, GDH shifts from an open conformation (the catalytic pocket, with binding sites for glutamate and NADH, is open) to a closed conformation (the catalytic pocket is closed, and the reaction can take place)

Patients should contact their healthcare provider if diarrhea persists beyond 2-4 weeks after reaching a stable dose, as this may indicate inadequate tolerance or an alternative underlying condition requiring investigation

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