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It also enhances the activity of the transcription factor Nrf2, which regulates genes crucial for cellular redox homeostasis and safeguarding cells against oxidative damage (Liu Z

(2015) Oral N-acetylcysteine reduces plasma homocysteine concentrations regardless of lipid or smoking status

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Patients at highest risk include those in the dose-escalation phase, experiencing active gastrointestinal symptoms (nausea, vomiting, bloating), those with known gastroparesis, or those taking concurrent medications that further delay gastric emptying (such as opioids)