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For gastrointestinal side effects , the following approaches are generally recommended: Gradual dose escalation : Starting at a low dose and increasing slowly over several weeks significantly reduces the severity of nausea and vomiting Dietary adjustments : Eating smaller, more frequent meals and avoiding high-fat or spicy foods can help manage nausea Hydration : Maintaining adequate fluid intake is important, particularly if diarrhoea or vomiting occurs, to reduce the risk of dehydration and acute kidney injury Temporary dose reduction or pause : If side effects are intolerable, pausing dose escalation or reducing the dose may be appropriate however, any change to dosing must only be made under the direction of the supervising clinician or in accordance with the trial protocol