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Your provider may consider temporarily reducing the dose by one tier, adding a prokinetic prescription like metoclopramide (5 to 10 mg before meals), or ordering gastric emptying testing if symptoms suggest an underlying motility disorder
Persistent nausea may prevent adequate food and fluid intake, while vomiting and diarrhea can lead to dehydration and electrolyte imbalances
Your patient will need a long-term plan to stay on track and keep the weight off
Commonly used agents for the treatment of melasma include hydroquinone, azelaic acid, kojic acid, glycolic acid, salicylic acid, and tretinoin
The good news is, if you lose a substantial amount of weight, visceral fat around the organsincluding the liver, kidney, and heartwill be reduced, which can help these organs function better, Apovian says
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