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Main Clinical Uses:- Heart Failure with reduced ejection fraction (selected patients) Rate control in Atrial Fibrillation, especially when accompanied by Heart Failure Narrow Therapeutic Index "The difference between an effective dose and a toxic dose is small" making careful monitoring essential

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The MC4R gene influences satiety and metabolic rate, potentially amplifying stomach discomfort if you have reduced receptor function

(An example of a minor exception: the drug alone was enough to improve relative leg strength, i.e