Grey-market quality varies
When enforcement intensity increases, gaps that were previously tolerated start showing up in FDA correspondence, on Form 483s, or during pre-approval inspections
However, the association between DPP-4 inhibitor use and suicidal behaviors mirrored that of GLP-1 RA, further supporting the accuracy of the findings
Second, and this is just as important, the cold environment itself creates a hostile setting for any potential microbial contaminants that might have been introduced
Tiny mineral crystals, such as uric acid or calcium oxalate, can appear due to nutritional factors or concentrated urine, but in higher amounts, they may signal kidney stone formation
doi: 10.3389/fphar.2026.1752204 Received 22 November 2025 Revised 15 April 2026 Accepted 21 April 2026 Published 15 May 2026 Volume 17 - 2026 Edited by Sathish Kumar Natarajan, University of Nebraska-Lincoln, United States Reviewed by Fabio Vivarelli, University of Bologna, Italy Vijay Radhakrishnan, University of Missouri, United States Updates Copyright 2026 Mahalingam, Kharbanda, Casey and Rasineni
