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With meals

By slowing down digestion, more gastrointestinal side effects can occur, including: Nausea Vomiting Diarrhea Constipation Bloating Indigestion Abdominal discomfort Sulfur burps (foul, rotten-egg-smelling burps) Acid reflux Why Side Effects Peak During Titration Medication can affect everyone differently, and so people may experience various side effects at different times while taking a drug, depending on their dosage and other factors

Recent research has added another layer of complexity

Controlled study on the therapeutic efficacy of propionyl-L-carnitine in patients with congestive heart failure

Additionally, individuals with a BMI of 27 or greater who also have conditions such as high blood pressure , type 2 diabetes, or high cholesterol may qualify for this treatment