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Yes, nausea can occur, especially early in treatment or after dose increases

The results showed that all three doses of tirzepatide led to more significant HbA1c reductions than 1mg of semaglutide

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Documented Heart Rate Increases : As noted in FDA prescribing information, semaglutide can increase resting heart rate by an average of 1-4 beats per minute, with some patients experiencing greater increases