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MGL has received particular attention in recent years due to the discovery that the enzyme is responsible for the inactivation of 2-arachidonoylglycerol (2-AG) which is an endogenous cannabinoid monoglyceride (endocannabinoid)
Patients receiving RYBELSUS in combination with an insulin secretagogue (e.g., sulfonylurea) or insulin may have an increased risk of hypoglycemia, including severe hypoglycemia
These could indicate liver enzyme changes that need testing
Beyond those concerns, experts point to several other potential downsides: Limited evidence for people without obesity or related conditions
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