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In QSYMIA clinical trials, the peak reduction in serum bicarbonate typically occurred within 4 weeks of titration to the assigned dose, and in most patients, there was a correction of bicarbonate by week 56, without any dosage reduction

Titrate: Step up to ~4,000 mcg (~15 units) around weeks 36 as tolerated

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2013;17(Suppl 1):S367-S373