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They are released when bacteria die and are not destroyed by standard sterilization methods autoclaving kills the organisms but leaves the endotoxin fragments intact

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avoiding high-fat foods), anti-nausea medications, or adjusting timing of administration Temporarily holding the dose : In cases of severe gastrointestinal symptoms or dehydration, a brief treatment pause may be appropriate Reviewing administration technique : For Rybelsus, ensuring strict adherence to the fasting window (4 oz water, 30 minute wait) before considering dose changes For patients with diabetes, dose adjustments must also consider glycemic control

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