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Metformin primarily reduces hepatic glucose production and improves peripheral insulin sensitivity, while tirzepatide enhances glucose-dependent insulin secretion, suppresses glucagon release, slows gastric emptying, and promotes satiety

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While the FDA rules do not directly prohibit physicians or other prescribers from ordering compound tirzepatide, 503A pharmacies and 503B outsourcing facilities will be unable to fill orders for compounded tirzepatide, unless an exception applies

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