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You might experience some common side effects such as dizziness, drowsiness, dry mouth, trouble sleeping, fatigue, tingling in the hands or feet, joint pain, constipation, or a metallic taste. These generally aren't serious, but if they persist or worsen, contact your healthcare provider. Many individuals using this medication experience no severe side effects, which can offer some reassurance.

However, there are more serious side effects to be aware of. Seek immediate medical attention if you notice signs of kidney stones (like painful urination, fever, chills, pink or bloody urine), bone pain, changes in sexual function, unusual bleeding or bruising, confusion, difficulty with concentration, or memory issues. A small number of people taking anticonvulsants, including this medication, might experience mood changes, depression, or suicidal thoughts. It's crucial to inform your healthcare provider right away if you or those around you observe any sudden changes in mood or behavior.

In rare cases, this medication can cause serious eye problems that could lead to permanent blindness, typically within the first month of treatment. If you experience sudden vision changes or eye pain, seek medical help immediately. Additionally, this drug may lead to a serious metabolic problem, particularly if combined with valproic acid. Symptoms like unexplained fatigue, vomiting, or mental changes should prompt immediate medical attention.

Very serious side effects, though rare, include rapid breathing, irregular heartbeat, severe headache, trouble speaking, seizures, or weakness on one side of the body. If you experience chest pain, difficulty breathing during physical activity, fainting, or swelling of the extremities, stop taking the medication and seek urgent care. Allergic reactions are also rare but require immediate medical help if you notice symptoms such as a rash, swelling, severe dizziness, or breathing difficulties.

Remember, this list doesn't cover all potential side effects. If you notice any other unusual effects, contact your healthcare provider promptly for advice.

Avoid using MAO inhibitors alongside this medication, as it may lead to a severe and potentially life-threatening interaction. This includes drugs such as isocarboxazid, linezolid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, and tranylcypromine. It is advised not to take most MAO inhibitors for at least two weeks before starting this treatment. Consult your doctor for guidance on when to begin or discontinue this medication.

This drug should not be combined with certain other medications due to the risk of serious interactions. Inform your doctor or pharmacist if you have used appetite suppressants like diethylpropion or ephedra/ma huang in the past year before starting this medication.

Other products that may interact include orlistat and stimulants like amphetamines, methylphenidate, or street drugs such as cocaine or MDMA ("ecstasy").

Inform your doctor or pharmacist if you are using other substances that cause drowsiness, such as alcohol, marijuana (cannabis), antihistamines like cetirizine and diphenhydramine, sleep or anxiety medications like alprazolam, diazepam, zolpidem, muscle relaxants, or opioid pain relievers like codeine.

Some products may contain ingredients that could elevate your heart rate or blood pressure. Discuss with your pharmacist the products you are using, especially cough-and-cold products or diet aids, to ensure safe use.

If you are using hormonal birth control such as pills, patches, or rings with this medication, notify your doctor if you experience any new spotting or breakthrough bleeding.

Caffeine may enhance the side effects of this medication. It is best to avoid consuming large quantities of caffeine-containing beverages like coffee, tea, and colas, eating large amounts of chocolate, or using nonprescription products with caffeine.

This medication may interfere with certain medical or laboratory tests, such as brain scans for Parkinson's disease, potentially leading to inaccurate results. Ensure that all laboratory personnel and your healthcare providers are aware of your medication use.