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doi: 10.1016/j.ejphar.2004.07.112

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Gastrointestinal effects are the most frequently reported side effects and include: Nausea (1224% of patients): Often most pronounced during treatment initiation and dose escalation, typically improving over time Diarrhea (1323% of patients): May be transient or persistent, requiring dietary modifications Vomiting (611% of patients): Can lead to dehydration if severe or prolonged Constipation (617% of patients): May require increased fiber intake and hydration Abdominal pain or discomfort (610% of patients): Usually mild to moderate in severity Decreased appetite : Therapeutic effect but may be excessive in some individuals These gastrointestinal symptoms generally diminish over several weeks as the body adjusts to the medication