Serious cardiovascular events (e.g. MI, stroke, unstable angina) may occur. Diarrhea may occur after start of treatment (serious consequences of diarrhea (hypovolemia, syncope) reported). Use associated with rare intestinal ischemic events. Use not permitted in the following situations: unstable angina, history of MI or stroke, hyperlipidemia, cigarette smoking, hypertension, or obesity, depression or anxiety, or any signs of suicidal ideation or behavior, and in diabetes. Use with caution in mild hepatic impairment. Not recommended with moderate or severe impairment.