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Rarely, more serious adverse effects may occur, including: Acute pancreatitis (severe abdominal pain radiating to the back) Gallbladder problems (right upper quadrant pain, particularly after meals) Hypoglycaemia (in patients taking concomitant diabetes medications) Acute kidney injury (usually secondary to severe dehydration) Worsening of diabetic retinopathy (in people with diabetes) Thyroid symptoms (persistent hoarseness, neck mass, difficulty swallowing) Patients should be educated about these warning signs and instructed to seek immediate medical attention if they occur