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It is essential to be aware of the safety information and warnings associated with Qsymia (phentermine/topiramate ER) to ensure its safe use. Below are critical points to consider:

• Pregnancy Risks: Do not use Qsymia if you are pregnant, as it can harm an unborn baby, potentially causing cleft lip. This is particularly a concern during the first trimester.

• Heart Health: This medication may increase heart rate by up to 20 beats per minute. Individuals with unstable heart health should be cautious, and heart health will be assessed before starting the medication. Report any significant increase in heart rate at rest to your healthcare provider.

• Mental Health Concerns: Qsymia contains topiramate, which may increase the risk of suicidal thoughts, depression, and anxiety, particularly in individuals with a history of mental health issues. Monitor mood changes closely, especially at the start of treatment or when adjusting doses, and inform a healthcare professional immediately if concerns arise.

• Vision Changes: Be alert for eye pain or nearsightedness, especially within the first month of treatment, as these symptoms could lead to serious eye problems if untreated.

• Cognitive Effects: The drug may impair concentration, memory, and language skills, particularly when starting at higher doses or increasing doses rapidly. Avoid alcohol, which can exacerbate these effects, and refrain from driving or operating heavy machinery until you understand how the medication affects you.

• Metabolic Acidosis: Rarely, Qsymia may increase blood acid levels, leading to potential kidney or bone issues. Regular blood tests may be required, and symptoms such as fast breathing, nausea, fatigue, or rapid heartbeat should be reported promptly.

• Blood Sugar Levels: Weight loss from Qsymia can reduce blood sugar levels, especially in those taking insulin or similar medications. Regularly monitor blood sugar and report persistent low levels to your prescriber.

• Blood Pressure Changes: Weight loss can also lower blood pressure, which may necessitate adjustments to blood pressure medications. Monitor your blood pressure and report any symptoms like dizziness or fainting.

• Temperature Regulation: The medication may impair sweating, affecting temperature control. Stay hydrated and take breaks in hot conditions.

• Allergic Reactions: Severe allergic reactions, including skin rashes and difficulty breathing, may occur. Immediate medical attention is necessary if these symptoms develop.

Contraindications: Do not use Qsymia if you are pregnant, have glaucoma, hyperthyroidism, or have used monoamine oxidase inhibitors (MAOIs) in the past 14 days. Always consult with your healthcare provider if these conditions apply to you.

It is crucial to adhere to these precautions and consult healthcare professionals for any concerns or in case of an overdose emergency.

When taking this medication, you may experience some common side effects such as dizziness, drowsiness, dry mouth, difficulty sleeping, tiredness, tingling sensations in the hands or feet, joint pain, constipation, and a metallic taste in your mouth. These effects are generally mild, but if they persist or worsen, it's important to consult your healthcare provider. Additionally, some people may notice changes in taste, headaches, or symptoms resembling a cold, such as a runny nose or sore throat.

More serious side effects, although less common, should be addressed immediately. These include signs of kidney stones, such as painful urination or bloody urine, bone pain, unusual bleeding or bruising, confusion, memory loss, or changes in sexual interest. It's crucial to be alert to any mood changes, including depression or suicidal thoughts, especially if you have a history of mental health issues.

In rare instances, this medication may lead to significant eye problems, potentially resulting in permanent vision loss. Seek medical help promptly if you experience sudden vision changes or eye pain. Another serious concern is a rare metabolic issue characterized by high ammonia levels in the blood, more likely if taken with valproic acid. Symptoms include sudden tiredness, vomiting, or altered mental state.

On very rare occasions, the medication can cause severe lung or heart problems, such as pulmonary hypertension or heart valve issues, especially with prolonged use or in combination with other appetite suppressants. Immediate medical attention is necessary if you experience chest pain, difficulty breathing, or swelling in the legs. Allergic reactions, although rare, require urgent care if you notice rash, swelling, severe dizziness, or breathing difficulties.

Always inform your healthcare provider of any side effects that you experience, even those not listed here, to ensure your safety while using this medication.

When taking Qsymia (phentermine/topiramate ER), it is important to be aware of potential drug interactions. Avoid using this medication with MAO inhibitors such as isocarboxazid, Linezolid, methylene blue, moclobemide, phenelzine, procarbazine, Rasagiline, safinamide, Selegiline, and Tranylcypromine, as these can lead to severe and potentially life-threatening reactions. Consult your doctor on the timing of starting or stopping these medications, especially since most MAO inhibitors should not be used for two weeks prior to beginning Qsymia.

Additionally, inform your doctor if you have used appetite suppressants like Diethylpropion or ephedra/ma huang in the past year, as combining these with Qsymia can lead to serious complications. Other drugs that may interact include Orlistat, other stimulants such as amphetamines and Methylphenidate, and recreational drugs like cocaine or MDMA.

Alert your healthcare provider if you are taking substances that induce drowsiness, including alcohol, cannabis, antihistamines (e.g., Cetirizine, diphenhydramine), sleep aids, anti-anxiety medications (e.g., Alprazolam, Diazepam, Zolpidem), muscle relaxants, and opioid pain relievers (e.g., codeine). These combinations may enhance sedative effects.

Some products containing ingredients that elevate heart rate or blood pressure, like certain cough-and-cold remedies or diet aids, may also interact with Qsymia. Discuss all such products with your pharmacist to ensure safe use.

If you are using hormonal contraceptives (e.g., pills, patches, rings) while on Qsymia, report any new spotting or breakthrough bleeding to your doctor. Caffeine can heighten Qsymia's side effects, so it is advisable to limit intake of caffeine-rich beverages, chocolates, or over-the-counter products containing caffeine.

Finally, Qsymia may interfere with specific medical or laboratory tests, such as brain scans for Parkinson's disease, potentially affecting the results. Ensure that all healthcare professionals involved in your care are aware of your Qsymia use.