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It is unknown whether Zepbound causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC) , in humans

Cytochromes P450 2E1 (CYP2E1) and 3A4 (CYP3A4) convert paracetamol to a highly-reactive intermediary metabolite, N-acetyl-p-benzo-quinone imine (NAPQI).[31][32][33] Under normal conditions, NAPQI is detoxified by conjugation with glutathione