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Less Common or More Serious Reactions Although uncommon, some patients may experience more pronounced adverse events, including: Vomiting or dizziness Temporary increases in blood pressure Elevated heart rate shortly after injection Gradual skin darkening with prolonged or frequent use These effects are typically transient, but they underscore the importance of medical screening and adherence to dosing guidelines

Genome Biol 9:R100 Lotze MT, Tracey KJ (2005) High-mobility group box 1 protein (HMGB1): nuclear weapon in the immune arsenal

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A randomized trial of mitriptyline and mexiletine for painful neuropathy in HIV infection.AIDS Clinical Trial Group 242 Protocol Team