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For patients experiencing significant symptoms, temporarily pausing therapy, maintaining the current dose for an additional 2-4 weeks before advancing, or implementing smaller dose increments when formulation allows, may improve tolerance

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Multiple factors unrelated to the medication may cause respiratory symptoms, including underlying cardiovascular disease, obesity-related conditions like sleep apnea, worsening GERD from delayed gastric emptying, anxiety or panic attacks, concurrent medications affecting breathing, or unrelated respiratory infections

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Physiological and Biochemical Zoology