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This document outlines essential safety information and warnings regarding the use of the medication Lomaira (phentermine). It is crucial to understand these details to ensure safe and effective use. Please consult with your healthcare provider if you have any questions or concerns.

• Combination with Other Weight Loss Medications: The safety of using Lomaira (phentermine) with other weight loss drugs, including over-the-counter options, is unknown. Avoid combining these medications without consulting your healthcare provider.

• Tolerance and Efficacy: Lomaira (phentermine) may lose effectiveness over time, a phenomenon known as tolerance. Increasing the dosage can lead to serious side effects and is not advisable. If you notice your appetite returning or weight gain after initial success, contact your healthcare provider for alternative treatment options.

• Risk of Misuse and Dependence: Lomaira (phentermine) carries a risk of misuse and dependence, similar to other stimulants. To mitigate these risks, it is typically prescribed for short-term use and in limited quantities. Follow your healthcare provider's prescription instructions closely and discuss long-term weight management strategies with your care team.

• Cognitive and Coordination Impairments: Lomaira (phentermine) may cause dizziness, difficulty concentrating, and coordination issues. Refrain from driving or engaging in tasks requiring high focus until you understand how the medication affects you. Report persistent side effects to your healthcare provider, who may suggest alternative treatments. Avoid alcohol consumption as it may exacerbate these effects.

• Cardiopulmonary Risks: Although rare, there have been severe cases of pulmonary hypertension and heart valve issues associated with the "fen-phen" combination (fenfluramine/phentermine). While these are unlikely with Lomaira (phentermine) alone, remain vigilant for symptoms such as chest pain, shortness of breath, swollen feet, or dizziness, and report them to your healthcare provider immediately.

• High Blood Pressure: Inform your healthcare provider if you have a history of high blood pressure, even if controlled. Lomaira (phentermine) may increase blood pressure, necessitating more frequent monitoring. Any significant changes should be reported to your provider for potential medication adjustment.

• Low Blood Sugar in Diabetics: Individuals with diabetes using medications like insulin or sulfonylureas may experience significantly low blood sugar levels due to changes in appetite and eating habits caused by Lomaira (phentermine). Your diabetes management team may need to adjust your medication dosages accordingly.

Contraindications: Lomaira (phentermine) should not be used if you have any of the following conditions, as it may lead to serious health complications. Consult your healthcare provider if any of these apply:

• Heart conditions (e.g., stroke, irregular heartbeat, uncontrolled high blood pressure)
• Overactive thyroid (hyperthyroidism)
• Glaucoma
• Agitation or distress
• History of substance use disorder
• Pregnancy or breastfeeding
• Recent or current use of monoamine oxidase inhibitors (MAOI) within the last 14 days
• Severe allergy to amphetamine-containing products

Please ensure you understand these safety guidelines and consult your healthcare provider for personalized advice.

When taking this medication, you might experience some common side effects, which are generally mild and manageable. These include dizziness, dry mouth, headaches, difficulty sleeping, irritability, nausea, vomiting, diarrhea, constipation, and restlessness. If these persist or worsen, consult your healthcare provider. Additionally, some individuals might notice changes in behavior, such as tremors or mood swings, and changes in sexual function or interest. Monitoring your blood pressure is important, as this medication can cause an increase, leading to symptoms like fast heart rate or high blood pressure.

However, there are more serious side effects that require immediate medical attention. These include fast or irregular heartbeat, mental changes such as agitation or hallucinations, and uncontrolled muscle movements. In rare cases, severe side effects like chest pain, severe headache, seizures, vision changes, or weakness on one side of the body may occur. These symptoms might indicate severe hypertension or heart and lung issues, such as pulmonary hypertension or heart valve problems, especially if accompanied by difficulty breathing, swelling of the legs, or fainting.

A very serious allergic reaction is rare, but watch for symptoms like rash, itching or swelling, severe dizziness, or trouble breathing. If any of these occur, seek medical help immediately. Always communicate with your healthcare provider about side effects and report any unusual symptoms.

When using this medication, it is crucial to be aware of potential interactions with other drugs. Inform your doctor if you have used appetite-suppressant medications like diethylpropion or ephedra/ma huang within the past year. Combining this drug with MAO inhibitors, such as isocarboxazid, linezolid, or phenelzine, can lead to severe, potentially life-threatening reactions. It is advised to avoid MAO inhibitors during treatment and for two weeks prior to starting this medication. Consult your doctor for specific guidance on timing.

This medication may also interact with high blood pressure drugs like guanethidine and methyldopa, phenothiazines such as prochlorperazine, and other stimulants including amphetamines and street drugs like cocaine. If you are taking medications that cause drowsiness, such as opioid pain relievers, alcohol, or drugs for anxiety and sleep, inform your healthcare provider. These include medications like alprazolam, lorazepam, and zolpidem.

Be cautious with products that might increase drowsiness or elevate heart rate and blood pressure, such as certain allergy or cough-and-cold remedies. Discuss with your pharmacist about using these products safely. Limit caffeine intake from sources like coffee, tea, and chocolate, as it can heighten the side effects of this medication.

Additionally, this medication may alter the results of certain medical tests, including brain scans for Parkinson's disease. Ensure your doctors and lab personnel are aware of your medication use to avoid false test results.