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The information below outlines essential safety warnings and contraindications associated with the use of this medication. It is crucial to understand these details fully and discuss any concerns with your healthcare provider.

• Pulmonary Hypertension Risk: This medication, known for its stimulant effects used in weight loss, can lead to a rare but potentially fatal condition called pulmonary hypertension. This occurs when the blood pressure in the arteries connecting the heart and lungs is too high, impairing blood flow and causing heart and lung issues. The risk increases significantly if the medication is used for more than three months. Signs to watch for include difficulty breathing, chest pain, fainting, or swelling in the lower extremities. These symptoms require immediate medical attention.

• Heart Valve Damage: There is a slight risk that this medication could cause heart valve issues, especially with long-term use or when combined with other appetite suppressants. Patients with existing heart conditions should be thoroughly evaluated by their healthcare provider before starting this medication.

• Potential for Misuse and Dependence: Due to its potential for habit formation, this medication should be prescribed cautiously, particularly for individuals with a history of substance misuse. Abrupt discontinuation after prolonged use may lead to withdrawal symptoms such as fatigue, mood swings, and changes in sleep patterns. Discussing the risks and benefits with your provider is essential before starting treatment.

Contraindications: The following conditions indicate when this medication should be avoided due to serious health risks:

• Existing pulmonary hypertension
• Overactive thyroid (hyperthyroidism)
• Severe coronary artery disease (CAD)
• Glaucoma
• Uncontrolled high blood pressure
• Current agitated or distressed mental state
• History of substance use disorder
• Concurrent use of other appetite-suppressing medications
• Use within 14 days of a monoamine oxidase inhibitor (MAOI)

Always consult with your healthcare provider if any of these conditions apply to you before considering this medication.

Common side effects:

• nausea
• vomiting
• diarrhea
• constipation
• dry mouth
• headaches
• nervousness
• jitteriness
• trouble sleeping
• changes in sex drive

Less common but important to monitor:

• dizziness
• drowsiness
• unpleasant taste in the mouth
• muscle pain
• increased sweating
• anxiety
• depressed mood
• blurred vision
• increase in blood pressure

Serious side effects:

• severe headaches
• trouble speaking
• seizures
• vision changes
• weakness on one side of the body
• pulmonary hypertension
• heart valve issues
• chest pain
• difficulty breathing
• reduced exercise capacity
• swelling in the legs, ankles, or feet
• serious allergic reaction
• 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, Metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, Rasagiline, safinamide, Selegiline, Tranylcypromine, brofaromine, clorgyline, furazolidone, iproniazid, lazabemide, nialamide, pargyline, sibutramine, toloxatone)
• Stimulants (amphetamines, Methylphenidate, cocaine, MDMA/ecstasy)
• Appetite suppressants (phentermine, ephedra/ma huang)

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

• Medications causing drowsiness (opioid painkillers such as codeine, hydrocodone, alcohol, marijuana, sleep or anxiety medications such as Alprazolam, Lorazepam, Zolpidem, muscle relaxants such as Carisoprodol, Cyclobenzaprine, antihistamines such as Cetirizine, diphenhydramine)
• Products raising heart rate or blood pressure (cough-and-cold products, diet aids)

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

• Caffeine (coffee, tea, colas, chocolate)