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The most common are gastrointestinal: Nausea the most frequently reported side effect, especially during dose increases Vomiting less common than nausea, but can occur during titration Diarrhea typically mild and temporary Constipation some patients experience this instead of or in addition to diarrhea Decreased appetite this is both a therapeutic effect and something patients notice as a side effect These side effects are generally most noticeable in the first few weeks of treatment or after a dose increase, and tend to improve as the body adjusts

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