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Mild nausea or constipation is common at the start we manage it with slow titration and supportive care

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But the calendar lag is real, and it stacks on top of HTA timelines, pricing negotiations, and national formulary listings

Patients should be reassured that these symptoms often improve with continued treatment as the body adapts to the medication

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Patients should contact their GP if they experience persistent vomiting, severe abdominal pain, signs of dehydration, or symptoms of hypoglycaemia