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Reduce if gastrointestinal symptoms remain severe after six or more weeks at a given dose level, if significant dehydration results from persistent vomiting or diarrhea, if heart rate increases beyond 15 beats per minute above baseline, or if the side effect burden is causing protocol abandonment
This is the larger of the two, covering gastroparesis (stomach paralysis), ileus (bowel obstruction), and related severe GI injuries
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