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Your provider may also recommend phentermine/topiramate if you have a history of GI problems, since GLP-1 medications can be accompanied with some nausea, vomiting, diarrhea, bloating, or constipation at first

doi: 10.1177/2045894020952023

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To open the vial, first remove the plastic flip-off cap or outer protective seal by gently lifting or twisting it away from the vial top

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I am told my next step would be fusion which I do not want