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It is contraindicated in people with cardiovascular disease such as uncontrolled high blood pressure, coronary artery disease, arrhythmias, or heart failure, as well as hyperthyroidism, and it should not be used within 14 days of a monoamine oxidase (MAO) inhibitor, among other cautions

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Even so, extensive human research is still vital

Most patients begin on a low starting dose and gradually move up based on tolerance and weight loss response