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9 Liver disease: No dose adjustment is required in people with liver impairment, although I would advise against use in those with severe hepatic impairment, because of the lack of experience in such individuals

DPP4 cleavage of the physiologically active BNP (132) to BNP (332) effectively lowers plasma cGMP levels, reduces diuresis and natriuresis, and inhibits vasodilatation (83, 202)

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