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Clinical trial data suggest that gastrointestinal side effects, including any reflux symptoms, typically improve over time as patients develop tolerance to the medication

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[DOI] [PubMed] [Google Scholar] 177.Mojsov S., Kopczynski M.G., Habener J.F

The microbiome consequences at that scale cannot be hand waived

Possible Risks and Downsides While dose splitting may help some individuals, there are also potential downsides