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In a zebrafish model, compared with C3-carnitine, C18-carnitine and C18:1-carnitine can induce the inhibition of OXPHOS, interfere with the energy supply of cardiomyocytes, and lead to a significant impairment of cardiac systolic function, which manifests as a decreased heart rate and reduced shortening of the atrial and ventricular fractions [21]

Novo also disclosed that several manufacturers filed abbreviated new drug applications for generic versions of Ozempic, Wegovy and Rybelsus with Paragraph IV certifications

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