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If the patient is receiving metformin, DPP-4 inhibitors (DPP-4i), GLP-1 receptor agonists GLP-1 RAs), and/or SGLT-2 inhibitors (SGLT-2i), these should be continued, and the discontinuation of pioglitazone should be considered

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Licensed 503A compounding pharmacies manufacture these medications under strict FDA oversight, maintaining identical purity and sterility standards as mass-produced alternatives