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A specific phenotype of cholangiocarcinoma with features of cholangiofibrosis consisting of dilated biliary glands, mucus production, intestinal metaplasia, inflammatory cell infiltrates, and fibrosis has been diagnosed in rats treated with a variety of hepatotoxic xenobiotics (Bannasch and Zerban 1990

D., Ceruelo, S., Ros, L., Bueno, O., Berrocal-Zaragoza, M

And if you are coming from semaglutide rather than injectable tirzepatide, the semaglutide to tirzepatide conversion chart is the starting reference before applying the sublingual bioavailability adjustment

Advances in treatment of progressive multifocal leukoencephalopathy

This is to prevent possible desensitization to the peptide, which can occur with continuous use