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Other risk groups include older adults, pregnant women, people taking metformin or long-term acid-suppressing medications (PPIs, H2 blockers), those with conditions affecting the gastrointestinal tract (pernicious anaemia, Crohn's disease, coeliac disease), and individuals who have undergone gastric or ileal surgery

It is thought to have a major role in neurotoxicity as well as the induction of CYP450 enzymes

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Combination therapy requires careful medical oversight to improve dosing and monitor for interactions

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