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Dehydration makes nausea significantly worse For diarrhea: Increase fiber intake gradually, not suddenly Stay hydrated with electrolyte solutions, not just plain water Avoid sugar alcohols and artificial sweeteners, which can worsen GI symptoms For constipation: Increase water intake to at least 2-3 liters daily Add magnesium citrate if needed (a gentle, effective option) Include high-fiber vegetables and fruits in your diet When to slow the escalation If you experience side effects that significantly impact your daily function, extend the current dose phase by 2-4 additional weeks before escalating

It does not act as a stimulant

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For doses under 0.3mL, a 0.3mL syringe provides the most accurate measurements

(d) Methodology To Estimate the Improvement Activities Performance Category Score For the baseline and policies model we used the same method to estimate the improvement activities performance category score as described in the CY 2025 PFS final rule (89 FR 79508) including alignment with the clarification provided regarding IA automatic weighting for APM participants (89 FR 79366)