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Consult your provider if you experience severe or persistent nausea and vomiting that prevents adequate food or fluid intake, signs of pancreatitis including severe abdominal pain , vision changes or signs of diabetic retinopathy progression if you have diabetes, severe constipation lasting more than a week despite interventions, rapid heart rate or chest pain, or complete lack of appetite suppression or weight loss after reaching 1mg dose for at least four weeks

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