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Inhibitors of DPP-4 showed only minimal pharmacokinetic changes in patients with varying degrees of hepatic impairment.70 Among agonists of GLP-1 receptors, only liraglutide has been studied in patients with CLD.72 No increase in liver enzymes was observed with this drug alone or combined with other agents

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Using nuclear magnetic resonance (NMR) spectroscopy, Smeland and colleagues also demonstrated increased levels of norepinephrine and serotonin in the cortex of healthy mice, after 25 days of treatment with acetylcarnitine at a daily dose of approximately 0.5 g/kg body weight [117]

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