I did get some nausea in the evening (but before I took it), and sometimes only felt like eating toast. I switched to the morning and that got better. I started on lowest does, 37.5 I think. Then after a month went to 75 i think, then up to 125 i think. Dr did say its the higher dose known to help hot flashes, but she started me low and increazed me 2 times gradually . I have heard insomnia is side effect of it, but I also take 1 Lorezapam at night to help me sleep.