May impair ability to engage in potentially hazardous activities. May cause increase in blood pressure (should not be used in coronary artery disease, heart failure, arrhythmia, or stroke). May cause increased heart rate (should not be used in coronary artery disease, congestive heart failure, arrhythmia, or stroke). Use of some anorexigens associated with development of valvular heart disease (avoid stimulants in known serious structural cardiac abnormalities, cardiomyopathy, serious heart rhythm abnormalities, or other serious cardiac problems which could increase risk of sudden death that these conditions alone carry). Use with caution in bleeding disorders, in diabetes mellitus (antidiabetic agent requirements may be altered with anorexigens and concomitant dietary restrictions), in history of gallstones (weight loss may precipitate or exacerbate gallstone formation), in narrow-angle glaucoma (risk of mydriasis), and in mild-moderate hepatic or renal impairment (avoid use in severe impairment). Use with caution in history of psychiatric symptoms (rare reports of depression, suicide and suicidal ideation documented in patients on sibutramine), in history of seizure disorder (seizures reported), and in Tourette’s syndrome (stimulants may unmask tics). Risk for development of serotonin syndrome if used with other serotonergic agents.