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Serious but less common adverse effects include pancreatitis, gallbladder disease, acute kidney injury (particularly in the setting of dehydration from gastrointestinal symptoms), and hypoglycemia when used in combination with insulin or sulfonylureas

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With oral supplements, portions of the vitamins and nutrients are lost to the digestive tract

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Lixisenatide In patients with mild and moderate renal impairment no dose adjustment is required but close monitoring for lixisenatide related adverse reactions and for changes in renal function is recommended because of higher incidences of hypoglycemia, nausea and vomiting that were observed in these patients