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Starting with a lower dose and gradually increasing it helps minimize these issues

Its rare and mostly avoidable by sticking to the dosing frequency I recommend

Hernandez AF, Green JB, Janmohamed S, D'Agostino RB Sr, Granger CB, Jones NP, Leiter LA, Rosenberg AE, Sigmon KN, Somerville MC, et al

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Discounted pricing at higher doses requires refilling within 45 days of the prior delivery

In a nonsurgical population-based cohort that included 25,617 patients, Faillie et al