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Changes in pH and ionic environment can alter amino acid side-chain charge, hydrogen bonding, peptide folding or association, and hydrophobic interactions

For nausea Nausea is the most commonly reported side effect, particularly during dose increases 3

But, as always happens with big pharma blockbusters, the research community is busy exploring other possible applications for this class of compounds, with clinical trials underway or forming in cardiovascular disease, chronic kidney disease and obstructive sleep apnea