Warnings and Precautions Contraindications
• Serotonin syndrome
• Valvular heart disease
• Cognitive impairment
• Psychiatric disorders
• Monitor for depression or suicidal thoughts
• Weight loss may cause hypoglycemia
• Has not been studied in patients taking
insulin
• Priapism
• Pregnancy and breastfeeding
Use with caution:
• SSRI
• SNRI/MAO inhibitor
• St. John's wort
• Triptans
• Bupropion
• Dextromethorphan
• Fetal toxicity (obtain negative pregnancy
test before treatment and monthly
thereafter; use effective contraception)
• Increase in heart rate
• Monitor for depression or suicidal thoughts
• Acute myopia and secondary angle
closure glaucoma
• Cognitive impairment
• Metabolic acidosis
• Elevated creatinine
• Weight loss may cause hypoglycemia
• Pregnancy and breastfeeding
• Hyperthyroidism
• Glaucoma
• MAO inhibitor
• Hypersensitivity or idiosyncracy to
sympathomimetic amines
• Boxed warning : thyroid C-cell tumors
• Warnings:
▶ Acute pancreatitis
▶ Acute gallbladder disease
▶ Serious hypoglycemia (when used
with an insulin secretagogue)
▶ Heart rate increase
▶ Renal impairment
▶ Hypersensitivity reactions
▶ Monitor for depression or suicidal
thoughts
• Personal or family history of medullary
thyroid carcinoma or Multiple Endocrine
Neoplasia type 2
• Hypersensitivity
• Pregnancy
• Coadministration with other drugs for
weight loss not recommended
• Rare cases of primary pulmonary
hypertension
• Rare cases of regurgitant cardiac valvular
disease
• Tolerance to anorectic effect
• May impair ability to engage in
potentially hazardous activities
• Risk of abuse and dependence
• Adverse reactions with concomitant
alcohol use
• Increased blood pressure
• May cause hypoglycemia with insulin or
oral hypoglycemic agents
• History of cardiovascular disease (e.g.,
coronary artery disease, stroke, arrhythmias,
congestive heart failure, uncontrolled
hypertension)
• During or within 14 days of taking MAOIs
• Hyperthyroidism
• Glaucoma
• Agitated states
• History of drug abuse
• Pregnancy
• Nursing
• Known hypersensitivity
