HOW TO USE
Take this medication by mouth as directed by your doctor, usually
once a day, 1 hour before breakfast or 1 to 2 hours after breakfast. If
needed, your doctor may adjust your dose to take a small dose up to 3
times a day. Carefully follow your doctor's instructions. Taking this
medication late in the day may cause trouble sleeping (insomnia).
If you are using sustained-release capsules, the dose is usually taken
once a day before breakfast or at least 10 to 14 hours before bedtime.
Swallow the medication whole. Do not crush or chew sustained-release
capsules. Doing so can release all of the drug at once, increasing the
risk of side effects.
Dizziness, dry mouth, difficulty sleeping, irritability, nausea,
vomiting, diarrhea, or constipation may occur. If these effects persist
or worsen, notify your doctor or pharmacist promptly.
Remember that your doctor has prescribed this medication because he or
she has judged that the benefit to you is greater than the risk of side
effects. Many people using this medication do not have serious side
Tell your doctor immediately if any of these unlikely but serious side
effects occur: fast/irregular/pounding heartbeat, mental/mood changes
(e.g., agitation, uncontrolled anger, hallucinations, nervousness),
uncontrolled muscle movements, change in sexual ability/interest.
Stop taking this medication and seek immediate medical attention if any
of these rare but very serious side effects occur: severe headache,
slurred speech, seizure, weakness on one side of the body, vision
changes (e.g., blurred vision).
This drug may infrequently cause serious (sometimes fatal) lung or heart
problems (pulmonary hypertension, heart valve problems). The risk
increases with longer use of this medication and use of this drug along
with other appetite-suppressant drugs/herbal products. If you notice any
of the following unlikely but very serious side effects, stop taking
this medication and consult your doctor or pharmacist immediately: chest
pain, difficulty breathing with exercise, decreased ability to
exercise, fainting, swelling of the legs/ankles/feet.
A very serious allergic reaction to this drug is rare. However, seek
immediate medical attention if you notice any of the following symptoms
of a serious allergic reaction: rash, itching/swelling (especially of
the face/tongue/throat), severe dizziness, trouble breathing.
This drug should not be used with certain medications because very
serious interactions may occur. If you are taking or have taken other
appetite-suppressant drugs in the past year (e.g., diethylpropion,
ephedra/ma huang), tell your doctor or pharmacist before starting this
Taking MAO inhibitors with this medication may cause a serious (possibly
fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid,
linezolid, methylene blue, moclobemide, phenelzine, procarbazine,
rasagiline, selegiline, tranylcypromine) during treatment with this
medication. Most MAO inhibitors should also not be taken for two weeks
before treatment with this medication. Ask your doctor when to start or
stop taking this medication.
Before using this medication, tell your doctor or pharmacist of all
prescription and nonprescription/herbal products you may use,
especially: drugs for depression (e.g., TCAs such as imipramine, SSRIs
and SNRIs such as paroxetine, fluoxetine, venlafaxine, duloxetine), high
blood pressure medicine (e.g., guanethidine, methyldopa),
phenothiazines (e.g., prochlorperazine, promethazine, chlorpromazine),
other stimulants (e.g., amphetamines, methylphenidate, street drugs such
as cocaine or MDMA/"ecstasy").
Tell your doctor or pharmacist if you also take drugs that cause
dizziness or drowsiness such as: certain antihistamines (e.g.,
diphenhydramine), anti-seizure drugs (e.g., carbamazepine), medicine for
sleep or anxiety (e.g., alprazolam, diazepam, zolpidem), muscle
relaxants, narcotic pain relievers (e.g., codeine), psychiatric
medicines (e.g., risperidone, amitriptyline, trazodone).
Also report the use of drugs which might increase seizure risk when
combined with this medication such as isoniazid (INH), phenothiazines
(e.g., thioridazine), theophylline, or tricyclic antidepressants (e.g.,
amitriptyline), among others.
Check the labels on all your medicines/herbal products (e.g.,
cough-and-cold products containing decongestants such as
pseudoephedrine, diet aids such as phenylpropanolamine, ephedra/ma
huang) because they may contain ingredients that could increase your
heart rate or blood pressure. Ask your pharmacist about using those
Caffeine can increase the side effects of this medication. Avoid
drinking large amounts of beverages containing caffeine (coffee, tea,
colas) or eating large amounts of chocolate.
This medication may interfere with certain medical/laboratory tests
(including brain scan for Parkinson's disease), possibly causing false
test results. Make sure laboratory personnel and all your doctors know
you use this drug.