Side Effects and Tolerability Differences Both medications work by slowing digestion and reducing appetite, so nausea, constipation, and mild diarrhea are common early side effects with either choice
Red-flag symptoms to call your clinician about Severe, persistent abdominal pain, especially radiating to the back (pancreatitis evaluation) Right-upper-quadrant pain, fever, jaundice (gallbladder disease) Severe vomiting, inability to tolerate fluids, or severe constipation/bloating (possible ileus or marked delayed emptying) Black stools or blood in stool/vomit (urgent evaluation) Product labels and FDA communications specify stopping the drug and urgent workup for suspected pancreatitis or gallbladder complications
It does not directly interact with alcohol, but alcohol can worsen GI side effects and is best limited during the first four to eight weeks of any escalation
Some find that increased hydration, especially with electrolytes, helps blunt the aftertaste or reduces the intensity of the metallic sensation on empty stomach