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RhoA GTPases regulate the formation of actin stress fibers and limit the size of the lamellipodium through their downstream effectors mDIA and ROCKs, which cycle between an inactive GDP-bound and an active GTP-bound form (Riento and Ridley, 2003

Beilstein Journal of Organic Chemistry

FDA-labeled warnings include: Risk of thyroid C-cell tumors (contraindicated in patients with personal/family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2) Pancreatitis (report severe abdominal pain, with or without vomiting) Gallbladder disease (including gallstones and cholecystitis) Acute kidney injury secondary to dehydration from gastrointestinal symptoms Hypoglycemia when used with insulin or insulin secretagogues (dose adjustments may be needed) Diabetic retinopathy complications in patients with type 2 diabetes and pre-existing retinopathy Suicidal behavior and ideation (monitor for depression or suicidal thoughts) Intestinal obstruction/ileus (particularly with severe constipation) These medications are contraindicated during pregnancy and should be discontinued at least two months before a planned pregnancy

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These programs often include medical consultations, nutritional support, and compounded versions of the medication, typically at a lower cost (ranging from $250 to $500/month)