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Accepted reasons for clinical necessity include: Intolerance to GI side effects requires a low-dose titration schedule not available commercially Need for split dosing across two or three weekly injections at doses not available commercially Allergy or sensitivity to an inactive ingredient in the commercial formulation, such as benzyl alcohol, excipients, or preservatives Requirement for a preservative-free formulation Therapeutic-additive requirements, such as leucine, methylcobalamin (B12), pyridoxine (B6), or L-carnitine A specific dose strength or concentration not available in any commercial format An alternative delivery method or dosage form not available commercially The clinical necessity must be explicitly documented on the prescription by the ordering prescriber

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Currently, 5-aminosalicylates, immunosuppressive agents, corticosteroids, and biological therapeutics are widely used in IBD therapy

The 1st phase in the pathway of glucose signaling, sees the electrogenic sodium-coupled glucose transporters 1 (SGLT1) mediated uptake of two Na + ions for every internalized glucose molecule (53)

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