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--- 5 Dosage Initial dose: 5 mg once daily (usually at bedtime) After 46 weeks Increase to 10 mg daily Severe cases: up to 23 mg daily (extended-release form) --- 6 Adverse Effects Common: Nausea Vomiting Diarrhea Insomnia Muscle cramps Fatigue Serious: Bradycardia Syncope GI bleeding QT prolongation (rare) Due to increased cholinergic activity

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