Do not take this medicine with any of the following medications:

-MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate
This medicine may also interact with the following medications:

-acetazolamide
-alcohol
-antihistamines for allergy, cough and cold
-atropine
-birth control pills
-carbamazepine
-certain medicines for bladder problems like oxybutynin, tolterodine
-certain medicines for depression, anxiety, or psychotic disturbances
-certain medicines for high blood pressure
-certain medicines for Parkinson''s disease like benztropine, trihexyphenidyl
-certain medicines for sleep
-certain medicines for stomach problems like dicyclomine, hyoscyamine
-certain medicines for travel sickness like scopolamine
-dichlorphenamide
-digoxin
-diuretics
-linezolid
-medicines for colds or breathing difficulties like pseudoephedrine or phenylephrine
-medicines for diabetes
-methazolamide
-narcotic medicines for pain
-phenytoin
-sibutramine
-stimulant medicines for attention disorders, weight loss, or to stay awake
-valproic acid
-zonisamide

They need to know if you have any of these conditions:

-bone problems
-depression or other mental illness
-diabetes
-diarrhea
-glaucoma
-having surgery
-heart disease
-high blood pressure
-history of drug abuse or alcohol abuse problem
-history of heart attack or stroke
-history of irregular heartbeat
-kidney disease or stones
-liver disease
-low levels of potassium in the blood
-lung or breathing disease, like asthma
-metabolic acidosis
-on a ketogenic diet
-seizures
-suicidal thoughts, plans, or attempt; a previous suicide attempt by you or a family member
-taken an MAOI like Carbex, Eldepryl, Marplan, Nardil, or Parnate in last 14 days
-thyroid disease
-an unusual or allergic reaction to phentermine, topiramate, other medicines, foods, dyes, or preservatives
-pregnant or trying to get pregnant
-breast-feeding

Visit your doctor or health care provider for regular checks on your progress.
Do not stop taking except on your health care provider''s advice. You may develop a severe reaction. Your health care provider will tell you how much medicine to take.
Do not take this medicine close to bedtime. It may prevent you from sleeping.
Avoid extreme heat. This medicine can cause you to sweat less than normal. Your body temperature could increase to dangerous levels, which may lead to heat stroke.
You should drink plenty of fluids while taking this medicine. If you have had kidney stones in the past, this will help to reduce your chances of forming kidney stones.
You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may increase dizziness and drowsiness. Avoid alcoholic drinks.
This medicine may affect blood sugar levels. Ask your healthcare provider if changes in diet or medicines are needed if you have diabetes.
Check with your health care professional if you have severe diarrhea, nausea, and vomiting, or if you sweat a lot. The loss of too much body fluid may make it dangerous for you to take this medicine.
Tell your health care professional right away if you have any change in your eyesight.
Patients and their families should watch out for new or worsening depression or thoughts of suicide. Also watch out for sudden changes in feelings such as feeling anxious, agitated, panicky, irritable, hostile, aggressive, impulsive, severely restless, overly excited and hyperactive, or not being able to sleep. If this happens, especially at the beginning of treatment or after a change in dose, call your healthcare professional.
This medicine may cause serious skin reactions. They can happen weeks to months after starting the medicine. Contact your health care provider right away if you notice fevers or flu-like symptoms with a rash. The rash may be red or purple and then turn into blisters or peeling of the skin. Or, you might notice a red rash with swelling of the face, lips or lymph nodes in your neck or under your arms.
Birth control may not work properly while you are taking this medicine. Talk to your health care professional about using an extra method of birth control.
Women should inform their health care provider if they wish to become pregnant or think they might be pregnant. There is a potential for serious side effects and harm to an unborn child. Losing weight while pregnant is not advised and may cause harm to the unborn child. Talk to your health care provider for more information.

Keep out of the reach of children. This medicine can be abused. Keep your medicine in a safe place to protect it from theft. Do not share this medicine with anyone. Selling or giving away this medicine is dangerous and against the law.
This medicine may cause harm and death if it is taken by other adults, children, or pets. Return medicine that has not been used to an official disposal site. Contact the DEA at 1-800-882-9539 or your city/county government to find a site. If you cannot return the medicine, mix any unused medicine with a substance like cat litter or coffee grounds. Then throw the medicine away in a sealed container like a sealed bag or coffee can with a lid. Do not use the medicine after the expiration date.
Store at room temperature between 15 and 25 degrees C (59 and 77 degrees F).