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The gut peptides signaling to the hypothalamus act via the ARC to mediate the appetite stimulation (+) effect through the activation of neurons containing neuropeptide Y (NPY) and Agouti-Related Peptide (AgRP) or appetite-inhibitory effects (-) via neurons containing the preopiomelanocortin (POMC)-derived alpha-melanocyte stimulating hormone (alpha-MSH) and cocaine and amphetamine regulated transcript (CART) peptide to hunger centers in the LHA, the satiety center in PVN in the medial hypothalamus (16)

On very rare occasions, more serious issues have been reported

Other medicines Microorganisms in the digestive system may directly participate in the absorption and metabolism of medicines

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