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Common side effects reported with Melanotan II include: Nausea and vomiting Facial flushing Cardiovascular effects including potential blood pressure changes Spontaneous erections (priapism risk) Darkening of skin and moles Potential effects on existing moles or skin lesions Of particular concern is the risk of priapism a prolonged, painful erection lasting more than four hourswhich constitutes a medical emergency requiring immediate treatment to prevent permanent damage to penile tissue