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If side effects are severe or persistent beyond the first few weeks, your GP or diabetes specialist may suggest: Temporary dose reduction Anti-emetic medication for nausea Review of concomitant diabetes medications to reduce hypoglycaemia risk Alternative GLP-1 receptor agonist formulations if oral semaglutide remains poorly tolerated According to NICE guidelines (NG28) , treatment decisions should be individualised based on efficacy, tolerability, patient preference, and cost-effectiveness