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However, if acid reflux becomes severe, affects daily life, or leads to complications such as difficulty swallowing, chronic cough, or chest pain, stopping the medication may be necessary

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As a competitive inhibitor of xCT, it promotes GSH consumption while inhibiting the expression of the antioxidant H2S-producing enzyme cystathionine-synthase (CBS) to achieve oxidative stress toxicity

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This stepwise intensification strategy is supported by guidelines and aims to balance glycemic efficacy with simplicity and patient tolerability [52]