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However, when combined with other blood sugar-lowering medications such as sulfonylureas or insulin, the risk of hypoglycemia may increase

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However, LVF triple therapy is not recommended as a first-line choice for most patients because resistance to LVF is increasing worldwide, but in areas of low LVF resistance and high CLR and MTZ resistance or unavailability of bismuth, this therapy can be used (OMorain et al