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Common ones reported by the Government of Canada include nausea, vomiting, diarrhea, and loss of appetite, especially when starting the medication or increasing the dose
[1] [2] The main concerns with combined use are related to overlapping effects on appetite, gastrointestinal function, and cardiovascular system, as well as potential impacts on medication adherence and diabetes self-management
For those whose symptoms interfere with daily life, staying on a lower dose for a longer period or even maintaining a reduced dose can improve both adherence and overall tolerability
After that, they may increase the dose by 0.5mg per week
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