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This document outlines important safety information and warnings regarding the use of this medication. It is essential to understand the potential risks and consult your healthcare provider with any concerns.

• Pulmonary Hypertension: This medication, which has stimulant properties for weight loss, can lead to a rare but serious condition known as pulmonary hypertension, especially if used for more than three months. Symptoms to watch for include difficulty breathing, chest pain, fainting, or swelling in the ankles, feet, or legs. Immediate consultation with your healthcare provider is advised if these symptoms occur.

• Heart Valve Issues: There is a potential risk of heart valve damage with this medication, particularly with long-term use or when combined with other appetite suppressants. If you have a history of heart conditions, inform your doctor as they will assess your heart function prior to starting treatment.

• Potential for Misuse and Dependence: Due to the habit-forming nature of this medication, caution is advised for individuals with a history of substance misuse or dependence. Abrupt cessation after long-term use may lead to withdrawal symptoms such as fatigue, mood swings, and sleep disturbances. It is crucial to evaluate the risks and benefits with your healthcare provider before incorporating this medication into your weight loss plan.

The following conditions indicate when this medication should not be used due to potential serious health risks. Consult your healthcare provider if any of these apply:

• Pulmonary hypertension
• Overactive thyroid (hyperthyroidism)
• Severe coronary artery disease (CAD)
• Glaucoma
• Uncontrolled high blood pressure
• Agitation or distress
• History of substance use disorder
• Concurrent use with other appetite-suppressing medications
• Use within 14 days of a monoamine oxidase inhibitor (MAOI)

Common side effects:

• Dizziness
• Nausea
• Vomiting
• Diarrhea
• Constipation
• Dry mouth
• Headache
• Nervousness
• Irritability
• Trouble sleeping

Less common but important to monitor:

• Higher blood pressure
• Jitteriness
• Drowsiness
• Unpleasant taste in the mouth
• Muscle pain
• Excessive sweating
• Anxiety
• Depressed mood
• Blurred vision
• Changes in sexual interest

Serious side effects:

• Severe headaches
• Trouble speaking
• Seizures
• Weakness on one side of the body
• Vision changes
• Chest pain
• Shortness of breath
• Swelling of the legs, ankles, or feet
• Rash
• Itching
• Swelling of the face, tongue, or throat
• Severe dizziness
• Difficulty breathing

Interactions with high risk of serious adverse effects and should be avoided:

• MAO inhibitors (isocarboxazid, Linezolid, phenelzine, etc.)
• Stimulants (amphetamines, Methylphenidate, cocaine, MDMA)
• Appetite suppressants (phentermine, ephedra/ma huang)

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Opioids (codeine, hydrocodone)
• Alcohol
• Cannabis
• Sleep or anxiety medications (Alprazolam, Lorazepam, Zolpidem)
• Muscle relaxants (Carisoprodol, Cyclobenzaprine)
• Antihistamines (Cetirizine, diphenhydramine)
• Iobenguane I 131

Interactions with low risk that usually do not require a change in therapy:

• Caffeine
• Chocolate