| Take this drug by mouth, generally three times daily during (or up to one hour after) each main meal that contains fat. Your daily intake of fat, protein and carbohydrate should be evenly spread over three main meals. If a meal is occasionally missed or contains no fat, skip that dose of the medication. Because this drug can interfere with absorption of fat-soluble vitamins (e.g., A,D,E,K), a daily multivitamin supplement containing these nutrients is recommended. Take the multivitamin at least 2 hours before or 2 hours after this drug (e.g., at bedtime). The effects of this drug may begin as soon as 1-2 days after treatment begins; noticeable weight loss will take longer. Tell your doctor of all nonprescription and prescription medication you may use, especially other weight reducing agents (e.g., diethylpropion), drugs that can raise blood pressure such as decongestants (e.g., pseudoephedrine, phenylpropanolamine), cough suppressants (e.g., dextromethorphan), antidepressants (e.g., nefazodone, fluoxetine, paroxetine, sertraline, fluvoxamine, venlafaxine), lithium, psychiatric medications (e.g., MAO Inhibitors such as selegiline, moclobemide, furazolidone, phenelzine, tranylcypromine), drugs for migraines (e.g., dihydroergotamine, sumatriptan), tryptophan, certain narcotic pain relievers (e.g., meperidine, pentazocine, fentanyl), ketoconazole, erythromycin, high blood pressure medicine or any drugs which can cause drowsiness, including certain antihistamines (e.g., diphenhydramine), sedatives and anti-seizure drugs. Antihistamines and decongestants may be found in many nonprescription drugs for cough and cold. Consult your pharmacist. MAO Inhibitors (see above) and this drug should not be taken together. If an MAO Inhibitor or this drug is stopped, wait 2 weeks before starting the other drug. Fatty/oily stool, oily spotting, intestinal gas with discharge, bowel movement urgency, poor bowel control, or headaches may occur. If these effects persist or worsen, notify your doctor promptly. Intestinal side effects (e.g., oily stool) may increase in intensity if you exceed your daily dietary fat allowance. Tell your doctor immediately if you have any of these unlikely but serious side effects: swelling of the feet or ankles. If you notice other effects not listed above, contact your doctor or pharmacist. |