I understand that as part of my healthcare, the healthcare providers of 4 You LLC. originates and maintains health records describing my health history, symptoms, examination and test results, diagnosis, treatment and any plans for future care or treatment. I understand that this information is utilized to plan my care and treatment, to bill for services provided to me, to communicate with other healthcare providers and other routine healthcare operations such as assessing quality and reviewing competence of healthcare professionals. 4 You LLC. Notice of Privacy Practices provides specific information and complete description of how my personal information may be used and disclosed. I understand that a copy of the Notice of Privacy Practices is available at the front desk and understand that I have the right to review the notice prior to signing this consent. I understand that 4 You LLC. reserves the right to change the Notice of Privacy Practices. Prior to implementation of the revised Notice of Privacy Practices, there vised Notice will be mailed to me if I provide my address below. I understand I have the right to restrict the use and/or disclosure of my personal health information for treatment, payment, or healthcare operations and that 4 You LLC. is not required to agree to the restrictions requested. I may revoke this consent at any time in writing except to the extent that 4 You LLC. has already taken action in reliance on my prior consent. This consent is valid until revoked by me in writing. We may change our policies and this notice at any time and have those revised policies apply to all the protected health information we maintain. If or when we change our notice, we will post the new notice in the office where it can be seen. You can request a paper copy of this notice, or any revised notice, at any time (even if you have allowed us to communicate with you electronically).

For more information about this notice or our privacy practices and policies, please contact the person listed at the end of this document.

NOTE: 4 You LLC. must obtain your written authorization to use your Private Health Information for any purpose other than treatment or billing. If you want 4 You LLC. to have access to disclose your Private Health Information to your spouse or any other person during your treatment, please sign below.

This information is for use by the parties named above only, and may not be disclosed to any other individual or agency without the patient’s consent or as otherwise provided by law. This authorization is subject to revocation at any time except to the extent the 4You, LLC has already taken action in reliance on it.

I understand that the information in my medical records may include information related to sexually transmitted disease, AIDS/HIV testing or diagnosis, mental health services, or drug/alcohol abuse diagnosis or treatment, and/or AIDS (Acquired Immunodeficiency Syndrome). Information in the form of audio, photo, or video has been designated above, if applicable.

I understand that 4 You, LLC, Ashley Caldwell, Certified Nurse Practitioner with NPI: 790336741, will not withhold health care if I do not sign this consent, but that exchange of private information with an outside entity such as a future employer or consulting physician will not be made without my consent. A copy of this consent and annotation concerning the persons or agencies with which information was exchanged will be included in my medical records. I understand that health information exchanged under this consent might be redisclosed by a recipient and no longer be protected by privacy laws.

I, the above named patient authorize the staff of 4You LLC to assist me with my weight loss journey. I understand that the weight loss program will consist of caloric deficit, intermittent fasting, exercise, behavioral modifications, and possibly medications.  I further understand the importance of independently reviewing the medication options, discussing those options with the care provider, as well as a pharmacist when obtaining my medications.  I will review and acknowledge I understand the risks associated with each medication after reading the package insert information for each mediation below.  If a package insert is not available on a medication I am trialing, I understand it is my full responsibility to ask questions and be comfortable with the risk vs benefits of the medications prior to starting treatment. I also understand that there are certain risks by remaining overweight or in poor health which include, but are not limited to: diabetes, hypertension, coronary artery disease, high cholesterol, sleep apnea, arthritis, along with many more.

Common side effects of weight loss medication include but are not limited to: headache, dry mouth, nausea, gastrointestinal disruption, constipation, weakness, fatigue, high blood pressure, rapid heart beat, heart rhythm irregularities, among many others.  I am willing to take the risk with the medications prescribed and will not hold any of the staff at 4You LLC responsible for adverse side effects related to any weight loss medication or weight loss activity.  

I understanddd that the success of the program depends on my efforts and are not guaranteed.  

Semaglutide (Ozempic, Wegovy, or compounded semaglutide/cyanocobalamin):

This is an injectable prescription medicine used with a reduced calorie diet and increased physical activity:

• To reduce the risk of major cardiovascular events such as death, heart attack, or stroke in adults with known heart disease and with either obesity or overweight.
• That may help adults and children aged 12 years and older with obesity, or some adults with overweight who also have weight-related medical problems, to help them lose excess body weight and keep the weight off.

Semaglutide (Ozempic, Wegovy, or compounded semaglutide/cyanocobalamin) should not be used with other semaglutide-containing products or other GLP-1 receptor agonist medicines.

Important Safety Information 
What is the most important information I should know about Semaglutide (Ozempic, Wegovy, or compounded semaglutide/ cyanocobalamin?

May cause serious side effects, including:

• Possible thyroid tumors, including cancer. Tell your healthcare provider if you get a lump or swelling in your neck, hoarseness, trouble swallowing, or shortness of breath. These may be symptoms of thyroid cancer. In studies with rodents, Semaglutide(Ozempic, Wegovy, Semaglutide/cyanocobalamin) and medicines that work like semaglutide (Ozempic, Wegovy, Semaglutide/cyanocobalamin) caused thyroid tumors, including thyroid cancer. It is not known if semaglutide will cause thyroid tumors or a type of thyroid cancer called medullary thyroid carcinoma (MTC) in people
• Do not use semaglutide(Ozempic, Wegovy, Semaglutide/cyanocobalamin) if you or any of your family have ever had a type of thyroid cancer called medullary thyroid carcinoma (MTC) or if you have an endocrine system condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)

Do not use semaglutide (Ozempic, Wegovy, or compounded semaglutide/ cyanocobalamin) if:

• You or any of your family have ever had a type of thyroid cancer called medullary thyroid carcinoma (MTC) or if you have an endocrine system condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
• You have had a serious allergic reaction to semaglutide or any of the ingredients in semaglutide (Ozempic, wegovy, or compounded semaglutide/cyanocobalamin.

Before using Semaglutide (Ozempic, Wegovy, or compounded semaglutide/cyanocobalamin) tell your healthcare provider if you have any other medical conditions, including if you:

• Have or have had problems with your pancreas or kidneys
• Have type 2 diabetes and a history of diabetic retinopathy
• Have or have had depression, suicidal thoughts, or mental health issues
• Are pregnant or plan to become pregnant. Semaglutide (Ozempic, Wegovy, Semaglutide/cyanocobalamin) may harm your unborn baby. You should stop using semaglutide (Ozempic, Wegovy, Semaglutide/cyanocobalamin) 2 months before you plan to become pregnant
• Are breastfeeding or plan to breastfeed. It is not known if semaglutide (Ozempic, Wegovy, Semaglutide/cyanocobalamin) passes into your breast milk

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Semaglutide (Ozempic, Wegovy, compounded semaglutide/cyanocobalamin) may affect the way some medicines work and some medicines may affect the way semaglutide works. Tell your healthcare provider if you are taking other medicines to treat diabetes, including sulfonylureas or insulin. Semaglutide (Ozempic, Wegovy, or compounded Semaglutide/cyanocobalamin) slows stomach emptying and can affect medicines that need to pass through the stomach quickly.

Safety Summary 

Warnings - Tirzepatide (Mounjaro, Zepbound, or compounded tirzepatide with niacinamide): may cause tumors in the thyroid, including thyroid cancer. Watch for possible symptoms, such as a lump or swelling in the neck, hoarseness, trouble swallowing, or shortness of breath. If you have any of these symptoms, tell your healthcare provider.

• Do not use Tirzepatide (Mounjaro, Zepbound, or compounded tirzepatide with niacinamide) if you or any of your family have ever had a type of thyroid cancer called medullary thyroid carcinoma (MTC). 
• Do not use Tirzepatide (Mounjaro, Zepbound, or compounded tirzepatide with niacinamide) if you have Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
• Do not use Tirzepatide (Mounjaro, Zepbound, or compounded tirzepatide with niacinamide) if you are allergic to it or any of the ingredients in Tirzepatide (Mounjaro, Zepbound, or compounded tirzepatide with niacinamide).

Serious side effects, including:

Inflammation of the pancreas (pancreatitis). Stop using Tirzepatide (Mounjaro, Zepbound, or compounded tirzepatide with niacinamide) and call your healthcare provider right away if you have severe pain in your stomach area (abdomen) that will not go away, with or without vomiting. You may feel the pain from your abdomen to your back.

Low blood sugar (hypoglycemia). Your risk for getting low blood sugar may be higher if you use Tirzepatide (Mounjaro, Zepbound, or compounded tirzepatide with niacinamide) with another medicine that can cause low blood sugar, such as a sulfonylurea or insulin. Signs and symptoms of low blood sugar may include dizziness or light-headedness, sweating, confusion or drowsiness, headache, blurred vision, slurred speech, shakiness, fast heartbeat, anxiety, irritability, or mood changes, hunger, weakness and feeling jittery.

Serious allergic reactions. Stop using Tirzepatide (Mounjaro, Zepbound, or compounded tirzepatide with niacinamide) and get medical help right away if you have any symptoms of a serious allergic reaction, including swelling of your face, lips, tongue or throat, problems breathing or swallowing, severe rash or itching, fainting, or feeling dizzy, and very rapid heartbeat.

Kidney problems (kidney failure). In people who have kidney problems, diarrhea, nausea, and vomiting may cause a loss of fluids (dehydration), which may cause kidney problems to get worse. It is important for you to drink fluids to help reduce your chance of dehydration.

Severe stomach problems. Stomach problems, sometimes severe, have been reported in people who use Tirzepatide (Mounjaro, Zepbound, or compounded tirzepatide with niacinamide). Tell your healthcare provider if you have stomach problems that are severe or will not go away.

Changes in vision. Tell your healthcare provider if you have changes in vision during treatment with Tirzepatide (Mounjaro, Zepbound, or compounded tirzepatide with niacinamide).

Gallbladder problems. Gallbladder problems have happened in some people who use Tirzepatide (Mounjaro, Zepbound, or compounded tirzepatide with niacinamide). Tell your healthcare provider right away if you get symptoms of gallbladder problems, which may include pain in your upper stomach (abdomen), fever, yellowing of skin or eyes (jaundice), and clay-colored stools.

Changes in vision in patients with type 2 diabetes. Tell your healthcare provider if you have changes in vision during treatment with Zepbound.

Depression or thoughts of suicide. You should pay attention to changes in your mood, behaviors, feelings, or thoughts. Call your healthcare provider right away if you have any mental changes that are new, worse, or worry you.

Common side effects

The most common side effects of Tirzepatide (Mounjaro, Zepbound, or compounded tirzepatide with niacinamide) include nausea, diarrhea, decreased appetite, vomiting, constipation, indigestion, and stomach (abdominal) pain. These are not all the possible side effects of Tirzepatide (Mounjaro, Zepbound, or compounded tirzepatide with niacinamide). Talk to your healthcare provider about any side effect that bothers you or does not go away.

Before using Tirzepatide (Mounjaro, Zepbound, or compounded tirzepatide with niacinamide):

• Discuss with your provider if you plan to become pregnant. Tirzepatide (Mounjaro, Zepbound, or compounded tirzepatide with niacinamide) can weaken the efficacy of your birth control pills.

Review these questions with your healthcare provider:

• Do you have other medical conditions, including problems with your pancreas or kidneys, or severe problems with your stomach, such as slowed emptying of your stomach (gastroparesis) or problems digesting food?
• Do you take other diabetes medicines, such as insulin or sulfonylureas?
• Do you have a history of diabetic retinopathy?
• Are you pregnant, plan to become pregnant, breastfeeding, or plan to breastfeed? It is not known if Mounjaro will harm your unborn baby or pass into your breast milk.
• Do you take any other prescription medicines or over-the-counter drugs, vitamins, or herbal supplements?

Metformin is used to treat high blood sugar levels that are caused by a type of diabetes mellitus or sugar diabetes called type 2 diabetes. With this type of diabetes, insulin produced by the pancreas is not able to get sugar into the cells of the body where it can work properly. Using metformin alone, with a type of oral anti-diabetic medicine called a sulfonylurea, or with insulin, will help to lower blood sugar when it is too high and help restore the way you use food to make energy.

Before Using

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies. Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric. Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of metformin oral solution, extended-release oral suspension, and tablets in children 10 to 16 years of age. However, safety and efficacy of metformin extended-release tablets in the pediatric population have not been established.

Geriatric. Although appropriate studies on the relationship of age to the effects of metformin have not been performed in the geriatric population, geriatric-specific problems are not expected to limit the usefulness of metformin in the elderly. However, elderly patients are more likely to have age-related kidney problems, which may require caution in patients receiving metformin. This medicine is not recommended in patients 80 years of age and older who have kidney problems.

Breastfeeding. There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Drug Interactions. Please review full medication interactions by clicking this link: https://www.drugs.com/metformin.html

Precautions

It is very important that your doctor check your or your child's progress at regular visits, especially during the first few weeks that you take this medicine. Blood and urine tests may be needed to check for unwanted effects.

This medicine may interact with the dye used for an X-ray or CT scan. Your doctor should advise you to stop taking it before you have any medical exams or diagnostic tests that might cause less urine output than usual. You may be advised to start taking the medicine again 48 hours after the exams or tests if your kidney function is tested and found to be normal.

Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery or medical tests.

It is very important to carefully follow any instructions from your health care team about:

• Alcohol—Drinking alcohol may cause severe low blood sugar. Discuss this with your health care team.
• Other medicines—Do not take other medicines unless they have been discussed with your doctor. This especially includes nonprescription medicines such as aspirin, and medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems.
• Counseling—Other family members need to learn how to prevent side effects or help with side effects if they occur. Also, patients with diabetes may need special counseling about diabetes medicine dosing changes that might occur with lifestyle changes, such as changes in exercise or diet. Counseling on birth control and pregnancy may be needed because of the problems that can occur in pregnancy for patients with diabetes.
• Travel—Keep a recent prescription and your medical history with you. Be prepared for an emergency as you would normally. Make allowances for changing time zones and keep your mealtimes as close as possible to your usual mealtimes.
• In case of emergency—There may be a time when you need emergency help for a problem caused by your diabetes. You need to be prepared for these emergencies. It is a good idea to wear a medical identification (ID) bracelet or neck chain at all times. Also, carry an ID card in your wallet or purse that says that you have diabetes and a list of all your medicines.

Under certain conditions, too much metformin can cause lactic acidosis. The symptoms of lactic acidosis are severe and quick to appear, and usually occur when other health problems not related to the medicine are present and are very severe, such as a heart attack or kidney failure. Symptoms of lactic acidosis include abdominal or stomach discomfort, decreased appetite, diarrhea, fast or shallow breathing, a general feeling of discomfort, severe muscle pain or cramping, and unusual sleepiness, tiredness, or weakness.

If symptoms of lactic acidosis occur, you should get immediate emergency medical help.

This medicine may cause some premenopausal women who do not have regular monthly periods to ovulate. This can increase the chance of pregnancy. If you are a woman of childbearing potential, you should discuss birth control options with your doctor.

This medicine may cause hypoglycemia (low blood sugar). This is more common when this medicine is taken together with certain medicines. Low blood sugar must be treated before it causes you to pass out (unconsciousness). People feel different symptoms of low blood sugar. It is important that you learn which symptoms you usually have so you can treat it quickly. Talk to your doctor about the best way to treat low blood sugar.

Hyperglycemia (high blood sugar) may occur if you do not take enough or skip a dose of your medicine, overeat or do not follow your meal plan, have a fever or infection, or do not exercise as much as usual. High blood sugar can be very serious and must be treated right away. It is important that you learn which symptoms you have in order to treat it quickly. Talk to your doctor about the best way to treat high blood sugar.

High blood sugar may occur if you do not exercise as much as usual, have a fever or infection, do not take enough or skip a dose of your diabetes medicine, or overeat or do not follow your meal plan.

Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur, they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

• Abdominal or stomach discomfort
• Cough or hoarseness
• decreased appetite
• diarrhea
• fast or shallow breathing
• fever or chills
• general feeling of discomfort
• lower back or side pain
• Muscle pain or cramping
• painful or difficult urination
• sleepiness

Less common

• Anxiety
• blurred vision
• chest discomfort
• cold sweats
• coma
• confusion
• cool, pale skin
• depression
• difficult or labored breathing
• dizziness
• fast, irregular, pounding, or racing heartbeat or pulse
• feeling of warmth
• headache
• increased hunger
• increased sweating
• nausea
• nervousness
• nightmares
• redness of the face, neck, arms, and occasionally, upper chest
• Seizures
• shakiness
• slurred speech
• tightness in the chest
• unusual tiredness or weakness

Rare

• Behavior changes similar to being drunk
• difficulty with concentrating
• drowsiness
• lack or loss of strength
• restless sleep
• unusual sleepiness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

• Acid or sour stomach
• belching
• bloated
• excess air or gas in the stomach or intestines
• Full feeling
• heartburn
• indigestion
• loss of appetite
• metallic taste in the mouth
• passing of gas
• stomachache
• stomach upset or pain
• vomiting
• weight loss

Less common

• Abnormal stools
• bad, unusual, or unpleasant (after) taste
•  change in taste
• difficulty with moving
• discoloration of the fingernails or toenails
• flu-like symptoms
• joint pain
• rash
• sneezing
• stuffy or runny nose
• swollen joints 

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional. 

Phentermine is used to speed weight loss in overweight people. It is used together with diet and exercise to treat obesity, especially in people with risk factors such as high blood pressure, high cholesterol, or diabetes.

Phentermine is similar to an amphetamine. It stimulates the central nervous system (nerves and brain), which increases your heart rate and blood pressure and decreases your appetite.

Warnings
Do not use phentermine if you are pregnant or breastfeeding a baby.
You should not use phentermine if you have glaucoma, overactive thyroid, severe heart problems, uncontrolled high blood pressure, advanced coronary artery disease, extreme agitation, or a history of drug abuse.

Do not use this medicine if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine. A dangerous drug interaction could occur.

Before taking this medicine
You should not use phentermine if you are allergic to it, or if you have:

• A history of heart disease (coronary artery disease, heart rhythm problems, congestive heart failure, stroke);
• Severe or uncontrolled high blood pressure;
• Overactive thyroid;
• Glaucoma;
• Extreme agitation or nervousness; a history of drug abuse; or
• If you take other diet pills.

Do not use phentermine if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

Weight loss during pregnancy can harm an unborn baby, even if you are overweight. Do not use phentermine if you are pregnant. Tell your doctor right away if you become pregnant during treatment.

You should not breast-feed while using this medicine.

To make sure this medicine is safe for you, tell your doctor if you have:

• Heart disease or coronary artery disease;
• A heart valve disorder;
• High blood pressure;
• Diabetes (your diabetes medication dose may need to be adjusted); or
• Kidney disease

Side effects
Get emergency medical help if you have signs of an allergic reaction to phentermine: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Phentermine may cause serious side effects. Call your doctor at once if you have:

• feeling short of breath, even with mild exertion;
• chest pain, feeling like you might pass out;
• swelling in your ankles or feet;
• pounding heartbeats or fluttering in your chest;
• tremors, feeling restless, trouble sleeping;
• unusual changes in mood or behavior; or
• increased blood pressure - severe headache, blurred vision,
• pounding in your neck or ears, anxiety, nosebleed.

Common side effects of phentermine may include:

• itching;
• dizziness/headache;
• dry mouth;
• unpleasant taste;
• diarrhea;
• constipation;
• stomach pain; or
• increased or decreased interest in sex.
  

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect phentermine?
Taking phenterminephentermine together with other diet medications such as fenfluramine (Phen-Fen) or dexfenfluramine (Redux) can cause a rare fatal lung disorder called pulmonary hypertension. Do not take phentermine with any other diet medications without your doctor's advice.

Many drugs can interact with phentermine. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any medicine you start or stop using.

Do not take Qsymia if you are pregnant, planning to become pregnant, or become pregnant during Qsymia treatment; have glaucoma; have thyroid problems (hyperthyroidism); are taking certain medicines called monoamine oxidase inhibitors (MAOIs) or have taken MAOIs in the past 14 days; are allergic to topiramate, sympathomimetic amines such as phentermine, or any of the ingredients in Qsymia. See the end of the Medication Guide for a complete list of ingredients in Qsymia.

Side effects:

Birth defects (cleft lip/cleft palate). If you take Qsymia during pregnancy, your baby has a higher risk for birth defects called cleft lip and cleft palate. These defects can begin early in pregnancy, even before you know you are pregnant. Patients who are pregnant must not take Qsymia. Patients who can become pregnant should have a pregnancy test before taking Qsymia and every month while taking Qsymia and use effective birth control (contraception) consistently while taking Qsymia. Talk to your healthcare provider about how to prevent pregnancy.

If you become pregnant while taking Qsymia, stop taking Qsymia immediately, and tell your healthcare provider right away. Healthcare providers and patients should report all cases of pregnancy to FDA MedWatch at 1-800-FDA-1088, and the Qsymia Pregnancy Surveillance Program at 1-888-998-4887.

Qsymia may slow the increase in height in children 12 years and older.

Increases in heart rate. Qsymia can increase your heart rate at rest. Your healthcare provider should check your heart rate while you take Qsymia. Tell your healthcare provider if you experience, while at rest, a racing or pounding feeling in your chest lasting several minutes when taking Qsymia.

Visual field defects (independent of elevated intraocular pressure) have been reported in clinical trials and in post-marketing experience in patients receiving topiramate. In clinical trials, most of these events were reversible after topiramate discontinuation. If visual problems occur at any time during treatment, consider discontinuing Qsymia.

Suicidal thoughts or actions. Topiramate, an ingredient in Qsymia, may cause you to have suicidal thoughts or actions. Call your healthcare provider right away if you have any of these symptoms, especially if they are new, worse, or worry you: thoughts about suicide or dying; attempts to commit suicide; new or worse depression; new or worse anxiety; feeling agitated or restless; panic attacks; trouble sleeping (insomnia); new or worse irritability; acting aggressive, being angry, or violent; acting on dangerous impulses; an extreme increase in activity or talking (mania); other unusual changes in behavior or mood.

Serious eye problems, which include any sudden decrease in vision, with or without eye pain and redness or a blockage of fluid in the eye causing increased pressure in the eye (secondary angle closure glaucoma). These problems can lead to permanent vision loss-if not treated. Tell your healthcare provider right away if you have any new eye symptoms.

Qsymia may cause a severe rash with blisters and peeling skin, especially around the mouth, nose, eyes, and genitals (Stevens-Johnson Syndrome). Qsymia may also cause a rash with blisters and peeling skin over much of the body that may be life threatening (Toxic Epidermal Necrolysis). Call your healthcare provider right away if you develop a skin rash or blisters.

Common side effects of qsymia in adults include:

Numbness or tingling in the hands, arms, feet, or face (paraesthesia); dizziness; changes in the way foods taste or loss of taste (dysgeusia); trouble sleeping (insomnia); constipation; and dry mouth.

Common side effects of qsymia in children 12 years old and older include:

Depression, dizziness, joint pain, fever, flu, and ankle sprain.

Possible Side effects

Mood changes and trouble sleeping. Qsymia may cause depression or mood problems, and trouble sleeping. Tell your healthcare provider if symptoms occur.

Concentration, memory, and speech difficulties. Qsymia may affect how you think and cause confusion, problems with concentration, attention, memory, or speech. Tell your healthcare provider if symptoms occur.

Increases of acid in bloodstream (metabolic acidosis). If left untreated, metabolic acidosis can cause brittle or soft bones (osteoporosis, osteomalacia, osteopenia), kidney stones, can slow the rate of growth in children, and may possibly harm your baby if you are pregnant. Metabolic acidosis can happen with or without symptoms. Sometimes people with metabolic acidosis will: feel tired, not feel hungry (loss of appetite), feel changes in heartbeat, or have trouble thinking clearly. Your healthcare provider should do a blood test to measure the level of acid in your blood before and during your treatment with Qsymia.

Low blood sugar (hypoglycemia) in people with type 2 diabetes mellitus who also take medicines used to treat type 2 diabetes mellitus. Weight loss can cause low blood sugar in people with type 2 diabetes mellitus who also take medicines used to treat type 2 diabetes mellitus (such as insulin or sulfonylureas). You should check your blood sugar before you start taking Qsymia and while you take Qsymia.

High blood pressure medicines. If you are taking medicines for your blood pressure, your doctor may need to adjust these medicines while taking Qsymia.

Central Nervous System (CNS) side effects. The use of prescription sleep aids, anxiety medicines, or drinking alcohol with Qsymia may cause an increase in CNS symptoms such as dizziness and light-headedness. Do not drink alcohol with Qsymia.

Possible seizures if you stop taking Qsymia too fast. Seizures may happen in people who may or may not have had seizures in the past if you stop Qsymia too fast. Your healthcare provider will tell you how to stop taking Qsymia slowly.

Kidney stones. Drink plenty of fluids when taking Qsymia to help decrease your chances of getting kidney stones. If you get severe side or back pain, and/or blood in your urine, call your healthcare provider.

Decreased sweating and increased body temperature (fever). People should be watched for signs of decreased sweating and fever, especially in hot temperatures. Some people may need to be hospitalized for this condition.

Qsymia capsules contain the inactive ingredient FD&C Yellow No. 5 (tartrazine) which can cause allergic-type reactions (including bronchial asthma) in certain people, especially people who also have an allergy to aspirin.

Tell your healthcare provider if you have any side effect that bothers you or does not go away. These are not all the possible side effects of Qsymia. For more information, ask your healthcare provider or pharmacist.