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While taking this medication, you might experience some mild side effects such as tiredness, drowsiness, dizziness, loss of coordination, nervousness, tingling in the hands or feet, changes in taste perception, loss of appetite, diarrhea, or weight loss. These effects are typically not serious and may improve as your body adjusts to the medication. However, if they persist or worsen, it's important to consult your healthcare provider.

On rare occasions, more serious side effects can occur. Contact your healthcare provider immediately if you experience bone pain, symptoms of kidney stones (severe pain in the back, side, abdomen, or groin, fever, chills, painful or frequent urination, or blood in the urine), unusual bleeding or bruising, confusion, difficulty concentrating, memory loss, or trouble speaking. These require prompt medical attention.

Seek urgent medical assistance if you encounter very serious side effects such as rapid breathing or an irregular heartbeat. A small number of individuals taking anticonvulsants may develop depression, suicidal thoughts, or other mood changes. If you or someone close to you notices sudden mood changes, signs of depression, or thoughts of self-harm, contact your doctor immediately.

Rarely, this medication might cause a serious eye condition that could lead to permanent vision loss, usually within the first month of treatment. If you notice sudden changes in vision or eye pain, seek medical help right away. Additionally, this drug can rarely lead to a serious metabolic issue involving high ammonia levels in the blood, especially if taken with valproic acid. Symptoms like sudden tiredness, vomiting, or mental changes need immediate attention.

Allergic reactions to this medication are uncommon but can be severe. Get emergency help if you experience symptoms such as rash, severe dizziness, itching or swelling, particularly of the face, tongue, or throat, or difficulty breathing. This summary doesn't cover all possible side effects, so if you notice any other unusual symptoms, contact your healthcare provider.

Please refer to the Side Effects section as well. One product that can interact with this medication is Orlistat. This drug may reduce the effectiveness of hormonal contraceptives like pills, patches, or rings, potentially leading to pregnancy. It’s important to speak with your healthcare provider about using additional reliable birth control methods while on this medication. If you experience new spotting or breakthrough bleeding, inform your doctor, as these could indicate that your birth control is not functioning properly.

Additionally, let your doctor or pharmacist know if you are taking any other substances that can cause drowsiness. These include alcohol, marijuana (cannabis), antihistamines (such as Cetirizine, diphenhydramine), medications for sleep or anxiety (like Alprazolam, Diazepam, Zolpidem), muscle relaxants, and opioid pain relievers (such as codeine). Be sure to check the labels on all your medications, including those for allergies or cough and cold, as they may contain ingredients that cause drowsiness. Consult your pharmacist to ensure you are using these products safely.