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Pharmacokinetics of IGF-1 LR3 The extended half-life of IGF-1 LR3 stems from two features: the N-terminal extension physically blocks IGFBP binding, and reduced clearance via the IGFBP-ALS ternary complex slows hepatic filtration

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When kidney function declines: Drug clearance decreases Plasma concentration increases Risk of adverse drug reactions rises Common examples include: Aminoglycosides nephrotoxicity Metformin risk of lactic acidosis Digoxin toxicity This is why dose adjustment or interval modification is essential in such patients

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