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If any of the following persist beyond four weeks at 10mg, a temporary or permanent step back to 7.5mg may be appropriate: Daily nausea that interferes with normal activities Vomiting more than twice per week Inability to consume adequate protein (less than 60 grams daily) Persistent diarrhea causing dehydration concerns Weight loss exceeding 2% of body weight per week (too rapid) Stepping back is not failure

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