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Seek medical evaluation for: Severe abdominal pain , particularly if sharp, persistent, or localized to the upper abdomen or right side, which could indicate pancreatitis or gallbladder disease Signs of dehydration including decreased urination, dark urine, dizziness, rapid heartbeat, or extreme thirst Symptoms of hypoglycemia such as sweating, shakiness, confusion, irritability, dizziness, or blurred vision (risk is low with these medications alone but increases when combined with insulin or sulfonylureas) [16] [17] Persistent nausea lasting more than a week despite dietary modifications Inability to tolerate any food or liquids Symptoms of gastroparesis such as severe bloating, early satiety with very small amounts of food, or vomiting undigested food hours after eating Signs of gallbladder problems including right upper quadrant pain, fever, or yellowing of the skin or eyes (jaundice) Rare but serious complications require emergency care