Accepted answer
The honest answer is that the first eight weeks are the hard part and that most people who get through them stop having the conversation.
Symptom prevalence in trials, broadly: nausea a quarter to a half, diarrhoea and constipation each roughly ten to twenty per cent, vomiting rather less, with all rates rising with dose.
Gastrointestinal adverse events, indicative pooled rates
| Event | Active arm | Placebo arm | Timing |
|---|
| Nausea | 40–45 % | 15–20 % | Peaks 1–2 wk after each step |
| Vomiting | 15–25 % | 5–8 % | Follows nausea |
| Diarrhoea | 20–30 % | 10–15 % | Early, variable |
| Constipation | 20–25 % | 8–12 % | Later onset, persistent |
| Discontinuation for GI events | 4–7 % | 1–2 % | Mostly during escalation |
Ranges span agents and doses; read the specific prescribing information for a specific figure.
Anticipating a slower-than-label titration from the start is a legitimate approach and costs only time, since the exposure ceiling is the same.
Trial-reported incidence and discontinuation rates for gastrointestinal effects are published per agent and per dose and are the appropriate figures to quote.
Smaller meals, less fat, fluids between rather than with. In that order.
edited 14 Jul 2024 by fiadh_cronin — removed a claim I could not source