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Generic medications go through a Health Canada approval process to demonstrate that they work the same way in the body as the branded product

Liver/Biliary:Abnormal liver function, hepatitis, cholestatic jaundice, hepatic necrosis, and hepatic failure

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In many cell types, IGF-1 enhances CREB phosphorylation and controls CRE-containing genes, such as c-Fos and B-Cell Leukemia/Lymphoma 2 (Bcl-2) [55]

Although the data in this study cannot be extrapolated directly to humans, it does shed some light on potentially important physiologic effects of the medication. The decrease in lean mass with GLP-1 use was associated with a lesser decrease in skeletal muscle mass and a greater decrease in the size of metabolically active organs such as the liver