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Since respiration (breathing) is key to staying alive, any combination of drugs that seriously depresses respiration should only be used in extreme circumstances in a clinical setting where the patient can be monitored continuously and with intubation available as an option by trained experienced medical professionals like anesthesiologist or emergency medical doctors

Persistent diarrhea beyond the titration period warrants evaluation and potential dose adjustment

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J Clin Endocrinol Metab 102(3):914922

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