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When taking this medication, you might experience dizziness, dry mouth, trouble sleeping, irritability, nausea, vomiting, diarrhea, or constipation. These effects are generally mild, but if they persist or worsen, it is important to consult your healthcare provider. Additionally, keep an eye on your blood pressure as this medication may cause it to rise; report any high readings to your doctor.

More serious side effects, though less common, demand immediate attention. Contact your healthcare provider if you encounter a fast, irregular, or pounding heartbeat, changes in mental state such as agitation or hallucinations, uncontrolled muscle movements, or alterations in sexual function. Seek urgent medical care if you experience severe headache, difficulty speaking, seizures, weakness on one side of your body, or any changes in vision like blurred vision.

In rare cases, this medication can lead to serious heart or lung issues, including pulmonary hypertension and heart valve problems, especially with prolonged use or when combined with other appetite suppressants. If you experience chest pain, difficulty breathing during exercise, reduced ability to exercise, fainting, or swelling in the legs, ankles, or feet, stop taking the medication and consult a healthcare professional immediately.

Allergic reactions to this drug are very rare but can be severe. Seek immediate medical assistance if you notice symptoms such as rash, itching, swelling (particularly of the face, tongue, or throat), severe dizziness, or trouble breathing. If you observe any side effects not mentioned here, reach out to your healthcare provider for guidance.

Be aware that certain products could interact with this medication. Stimulants, including amphetamines, methylphenidate, and illicit substances like cocaine or MDMA ("ecstasy"), may cause interactions. Avoid using this medication with certain drugs due to the risk of severe interactions. If you have taken appetite suppressants such as phentermine or ephedra/ma huang within the past year, inform your doctor or pharmacist prior to starting this treatment.

Combining this medication with MAO inhibitors can lead to a dangerous, potentially fatal reaction. Do not use MAO inhibitors (e.g., isocarboxazid, linezolid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) while on this medication. Most MAO inhibitors should also not be used for two weeks before beginning this treatment. Consult your doctor on when to start or stop these medications.

Notify your healthcare provider if you are using other substances that cause drowsiness, such as opioid pain or cough medications (like codeine, hydrocodone), alcohol, cannabis, sleep aids, anti-anxiety medications (such as alprazolam, lorazepam, zolpidem), muscle relaxants (like carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine).

Examine the labels of all your medications, including those for allergies or colds, since they might contain ingredients that can induce drowsiness. Consult your pharmacist for guidance on using these products safely.

Some products may have components that elevate heart rate or blood pressure. Inform your pharmacist about all the products you are using and seek advice on their safe use, especially regarding cough-and-cold products or diet aids.

Caffeine can heighten the side effects of this medication. It is advisable to avoid consuming large quantities of caffeinated drinks (such as coffee, tea, colas) or chocolate.