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Routine testing of vitamin B12 levels in metformin-treated patients should be considered. Because metformin often causes digestive tract upset, many patients are also put on a proton pump inhibitor (PPIs) such as esomeprazole ( Nexium ), lansoprazole ( Prevacid ) or omeprazole ( Prilosec )

Durand P, Lussier-Cacan S, and Blache D (1997a)

Design of benzoxathiazin-3-one 1,1-dioxides as a new class of irreversible serine hydrolase inhibitors: discovery of a uniquely selective PNPLA4 inhibitor

This means what was a staple in many clinics yesterday may now be a significant administrative liability today

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So when peptide therapy came into playmore like, came crashing onto the sceneI felt as if I were behind the curve