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These include the following: Nausea and vomiting (these are common during the first few weeks of starting the medication or when you escalate the dose during the titration phase) Bloating Feeling of fullness or early satiety Stomach ache Constipation Diarrhea (less common) These effects indicate that the medication has started working

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Your doctors office handles the actual submission, but you can help by ensuring all relevant medical records are available and asking your doctor to include a detailed letter of medical necessity explaining your specific situation