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Most patients tolerate the medication very well, and if necessary the dose can be adjusted to minimize side effects

Red flag symptoms requiring urgent medical assessment include: Severe abdominal pain or distension , particularly if accompanied by vomiting Complete inability to pass stools or wind (absolute constipation), especially with pain or distension Rectal bleeding or blood in the stool Unexplained weight loss beyond that expected from the medication's therapeutic effect Persistent nausea and vomiting preventing adequate oral intake Signs of bowel obstruction , such as colicky pain, absolute constipation, and abdominal distension Severe persistent abdominal pain radiating to the back , which may indicate pancreatitis Right upper abdominal pain, fever or yellowing of the skin/eyes , which could suggest gallbladder problems For urgent advice, contact NHS 111 or your GP

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doi: 10.1016/S0140-6736(21)01751-7

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