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however, absorption may be erratic, particularly following oral administration

To counteract fluctuating efficacy in advanced stages of Parkinsons disease, some patients have an internal dopamine-producing pump that delivers dopamine continuously via an implanted probe into the small intestine or under the skin

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Finally, topiramate is contraindicated in patients undergoing concomitant metformin therapy in advanced renal failure, as both agents rely on renal clearance and share the risk of lactic acidosis

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