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Consistent with this observation, the combination of olmesartan and exenatide has been shown to attenuate the renal NADPH oxidase 4 (Nox4) expression in insulin-resistant Otsuka Long-Evans Tokushima Fatty (OLETF) rats (Rodriguez et al., 2020)

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Clinical outcome: Mucositis, stomatitis Severe myelosuppression (anaemia, leukopenia, thrombocytopenia) Nephrotoxicity, hepatotoxicity Life-threatening infections, bleeding High-risk groups: Elderly Patients with renal impairment Patients on high-dose methotrexate (oncology use) Concomitant nephrotoxic drugs Advice: Avoid NSAIDs with high-dose methotrexate

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