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Tiny spots on the face, neck, or chest may appear after strong coughing, vomiting, heavy lifting, or other straining
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Most gastrointestinal side effects diminish significantly after 48 weeks of continuous treatment at a stable dose, though individual experiences vary considerably
Maintaining patients at a given dose for an additional four weeks before escalation may be appropriate if gastrointestinal symptoms are difficult to characterize
Candidates with high metabolic resistance, strong hunger signals, or previous dieting plateaus may benefit most
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