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You may experience headaches or difficulty sleeping while taking this medication. These are common side effects and usually not serious, but if they persist or worsen, consult your healthcare provider. As your immune system strengthens, you might notice symptoms of previous infections returning or new symptoms if your immune system becomes overactive. This can happen soon after starting treatment or even months later. Seek immediate medical attention if you experience significant weight loss, extreme fatigue, persistent muscle aches, severe or unrelenting headaches, joint pain, numbness, or tingling in extremities, vision changes, fever, chills, swollen lymph nodes, breathing difficulties, cough, or non-healing skin sores.

Be alert for signs of an overactive thyroid, such as irritability, nervousness, heat intolerance, rapid or irregular heartbeat, bulging eyes, or a neck mass (goiter). Another rare but serious condition, Guillain-Barre syndrome, may cause unsteadiness, loss of coordination, difficulty swallowing, speaking, chewing, or eye movement problems. Mental health changes like depression or anxiety, and signs of kidney issues, such as altered urine output, should also prompt immediate medical consultation.

In rare instances, the drug may lead to severe liver problems or lactic acidosis, especially in women and obese patients. Symptoms such as persistent nausea, vomiting, appetite loss, stomach pain, yellowing of the skin or eyes, dark urine, deep or rapid breathing, and drowsiness require urgent medical care. Though rare, severe allergic reactions may occur, characterized by rash, itching, facial swelling, severe dizziness, or breathing difficulties. If you notice any other unusual effects not listed, contact your healthcare provider for advice.