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Tirzepatide (Zepbound) and orforglipron (Foundayo) carry the most explicit labeling on this point

Regarding synthesis of this unimolecular dual-agonist, as Gcg amino acid positions 3, 10, and 12 are of critical importance to GcgR activation, and as the N-terminal sequences of both Gcg and GLP-1 have capacity to bind the GLP-1R, the first 15 amino acids of the Gcg base sequence were left unmodified

This structural change allows them to stay active in the body much longer than the natural version, providing a sustained therapeutic effect

[1] [13] Deficiency [edit] Carnitine deficiency is rare in healthy people without metabolic disorders, indicating that most people have normal, adequate levels of carnitine normally produced through fatty acid metabolism