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So yes, its normal

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Tesofensine Side Effects Because tesofensine acts as a central nervous system stimulant, its side effects tend to be stimulant-related: Dry mouth reported by 3040% of participants in clinical trials Insomnia difficulty falling or staying asleep, particularly if taken later in the day Increased heart rate mean increases of 58 beats per minute were observed in trials

"Starting low allows the brain and gastrointestinal system to adapt, which helps minimize side effects like nausea, reflux or fatigue." This early phase of the GLP-1 process is known as titration, a carefully managed adjustment period

Age-related changes in skeletal muscle reactive oxygen species generation and adaptive responses to reactive oxygen species