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Kyle Kingsley, MD Chronic fatigue is one of the most commonand most frustratingcomplaints among midlife women in Rochester

it is the possibility of a more flexible treatment pathway, provided the patient remains supported and clinically monitored

A: According to medical guidance: Life-Threatening Symptoms (Call 911): Difficulty breathing or severe shortness of breath Swelling of face, lips, tongue, or throat Severe allergic reaction (anaphylaxis) Chest pain Severe abdominal pain not resolving Loss of consciousness Serious but Non-Emergency Symptoms (Contact Provider Immediately/Same Day): Severe persistent nausea or vomiting (risk of dehydration) Inability to keep down fluids Severe abdominal pain Yellowing of skin or eyes (jaundice) Decreased or no urination Vision changes Lump or swelling in neck New or worsening depression or suicidal thoughts Moderate Bothersome Symptoms (Contact Provider Within 24-48 Hours): Nausea interfering with daily activities Persistent diarrhea or constipation Significant injection site reactions Concerning hair loss Other symptoms significantly impacting quality of life Response Options : Provider may adjust dose (slower escalation or temporary reduction) Provider may prescribe additional medications for symptom management Provider may recommend medication switch In rare cases, may recommend discontinuation Never hesitate to contact provider about concerning symptoms

Clinics in Dermatology

2 mg/week: 5 weeks per vial 4 mg/week: 2.5 weeks per vial 5 mg/week: 2 weeks per vial 8 mg/week: 1.25 weeks per vial 10 mg/week: 1 week per vial This creates a planning challenge