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Prescribers initiating BPC-157 in patients with Child-Pugh A or B hepatic impairment should document: (1) the clinical rationale for peptide therapy, (2) the absence of an FDA-approved alternative for the target condition, (3) baseline hepatic function with planned monitoring intervals, and (4) the patient's informed consent acknowledging the investigational nature of the therapy and the specific evidence limitations in their population

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