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The FDA prescribing information for Vyleesi provides clinicians and patients with precisely characterized cardiovascular effects (peak systolic elevation of ~6 mmHg at 24 hours post-dose, returning to baseline within 12 hours), documented contraindications (uncontrolled hypertension, known cardiovascular disease), and management strategies for nausea (ondansetron 30 minutes pre-dose)

Biochem Pharmacol 164:3444 Pereira M, Jeyabalan J, Jorgensen CS, Hopkinson M, Al-Jazzar A, Roux JP, Chavassieux P, Orriss IR, Cleasby ME, Chenu C (2015) Chronic administration of glucagon-like peptide-1 receptor agonists improves trabecular bone mass and architecture in ovariectomised mice

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Thats why treatment begins at a low dose