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The most common side effects were: Nausea Vomiting Diarrhea Constipation Fatigue Abdominal discomfort Early satiety Injection site reactions Increased heart rate in the first 24 weeks, but that returned to normal after 24 weeks

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This pattern appears in newly prescribed patients and those on therapy for more than a year: evenings are a standard window, episodes are sudden, and people describe the sensation as unsteady rather than spinning vertigo

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