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A rapid escalation is associated with low blood sugar levels and severe GI side effects such as severe abdominal pain, nausea, vomiting, and inflammation of the pancreas (pancreatitis)
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After symptoms resolve, a slower re-escalation can be attempted, perhaps increasing by smaller increments than the standard protocol specifies
It is why the drug list is limited to a few products, and it is why the $50 you pay does not behave like a normal Part D copay (more on that in the cost section)
Patients and doctors have developed click charts to calculate exactly how many clicks are needed for a precise low dose
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