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A pragmatic monitoring framework might include: Baseline blood pressure measurement (ideally on two separate occasions) before initiating treatment Repeat measurements at each dose-escalation visit , typically every four weeks during titration Ongoing monitoring every three to six months once a stable maintenance dose is achieved Home blood pressure monitoring encouraged for patients with known hypertension or those on antihypertensive therapy

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Metoclopramide, an FDA-approved prokinetic for gastroparesis, carries a boxed warning for tardive dyskinesia and should generally be limited to 12 weeks or less of therapy

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