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We manage this with slow dose escalation, dietary timing strategies, and anti-nausea support when needed

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The gradual dose titration schedule as per the SmPC and BNF (starting at 0.25 mg once weekly for four weeks, then increasing to 0.5 mg, with further increases to 1 mg or 2 mg if needed) is specifically designed to minimise these gastrointestinal effects whilst allowing therapeutic benefit