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If gastrointestinal symptoms significantly impair quality of life or prevent medication adherence despite conservative management, healthcare providers may consider dose adjustment, alternative agents with potentially different side effect profiles, or referral to a gastroenterologist for specialized evaluation

This article explains when early dosing is appropriate, what precautions to observe, and how to manage missed doses

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it occurs in association with endocrine disorders, underlying malignancy, administration of certain drugs, or as in inherited disorder