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doi: 10.1517/17425247.4.5.547

Similarly, recruitment of participants with severe hepatic impairment into the hepatic impairment study was challenging and, despite a third study site being added and the recruitment period being prolonged, it was not possible to complete recruitment of seven participants into the severe hepatic impairment group

Its a peptide derived from a protein found in your stomach

The empty stomach requirement matters because food presence affects gastric pH and transit time
