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Post-marketing surveillance and long-term cardiovascular safety studies reveal no significant safety imbalances (Gallwitz, 2016)
Abbass NJ, Nahlawi R, Shaia JK, Allan KC, Kaelber DC, Talcott KE, et al

For many, this symptom is most common in the first few weeks of treatment or immediately following a dose increase

They can be worse in the morning or when lying down and may worsen with straining, coughing, or bending