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Persistent vomiting that prevents you from keeping down food or fluids, leading to dehydration Signs of dehydration , including dark urine, dizziness, reduced urination, or extreme thirst, which may lead to acute kidney injury Vomiting blood or passing black, tarry stools, which may suggest gastrointestinal bleeding Severe allergic reactions , such as difficulty breathing, facial swelling, or widespread rash (call 999 or go to A&E immediately) Signs of intestinal obstruction : progressive abdominal distension, severe constipation, inability to pass gas, persistent vomiting Contact your GP or prescribing clinician if: Nausea or vomiting persists beyond the first few weeks after a dose increase You experience significant unintentional weight loss beyond your target or cannot maintain adequate nutrition Gastrointestinal symptoms significantly impact your quality of life or daily functioning You develop new or worsening symptoms of gastroparesis, particularly if you have diabetes You notice changes in blood glucose control (for patients with diabetes) You experience symptoms of gallbladder problems, such as pain in the upper right abdomen, yellowing of skin or eyes, or fever Patients should also inform their healthcare provider if they are taking other medications that affect gastric emptying

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