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These include: Nausea (affecting up to 1 in 5 patients) usually most pronounced during dose escalation and often improves over time Diarrhoea may be mild to moderate and typically transient Vomiting less common than nausea but can occur, particularly in the first few weeks Constipation resulting from slowed gastric emptying Abdominal pain and bloating often related to delayed gastric emptying Reduced appetite this is an intended therapeutic effect but can be pronounced The frequency of these side effects tends to be dose-dependent, with higher rates at higher doses