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While some functional MOR regulatory mechanisms contributing to tolerance are clearly understood, there are large gaps in understanding the molecular processes responsible for loss of MOR function after chronic exposure to opioids

In some cases, patients with certain medical histories or conditions may need to consider alternative therapies or modify their treatment approach

Some patients experience mild gastrointestinal symptoms, particularly with oral peptides, or transient fatigue during the adjustment period

More substantial improvements , such as enhanced firmness and reduced discoloration, often develop between 48 weeks