is when you should be well on your way to a new lifestyle and ready to stop MERIDIA.

Appetite suppressants are not a substitute for proper diet. For maximum effects, this must be used in conjunction with a diet and exercise progra m.

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Side Effects
If you experience any of the following symptoms, call your doctor immediately:

- excessive sweating
- dilated pupils
- fast or irregular heartbeat
- vomiting
- extreme ex citement
- restlessness
- anxiety
- dizziness
- confusion
- loss of consciousness
- uncoordinated or abnormal movement
- flushing (feeling of warmth)
- difficul t speech
- eye pain
- tremor
- seizures
- chest pain
- excessive bruising or unusual bleeding
- rash
- hives

What special precautions should I follow?
Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. Although there is no sp ecific information comparing use of Meridia in the elderly with use in other age groups, this medicine is not expected to cause different side effects or problems in older people than it does in young er adults.

What Is It
Meridia (si-BYOO-tra-meen) is used together with a reduced-calorie diet to help you lose weight and to help keep the lost weight from returning. Meridia is thought to work by increasing the activity o f certain chemicals, called norepinephrine and serotonin, in the brain. This medicine is approved for use only in people who are very overweight.

MERIDIA is a short-term drug that helps you to start losing weight and then keep on going when you are ready to carry on, on your own. Your body starts to build up a resistance to the effects of MERIDIA after a few weeks of treatment, which
Remember that Meridia must never be taken within 2 weeks of using an MAO inhibitor such as Marplan, Nardil, or Parnate. The combination could lead to serious, even fatal, overstimulation.

Am ong the many drugs that pose a potential problem are the following:
- Fentanyl (Duragesic)
- Fluoxetine (Prozac)
- Fluvoxamine (Luvox)
- Ketoconazole (Nizoral)
- Lithium (Eska lith, Lithobid)
- Meperidine (Demerol)
- Naratriptan (Amerge)
- Paroxetine (Paxil)
- Pentazocine (Talwin NX, Talacen)
- Sertraline (Zoloft)
- Stimulants such as amphetami nes, Dexedrine, Desoxyn, Adderall, Didrex, and Ionamin
- Sumatriptan (Imitrex)
- Tryptophan (L-Tryptophan)
- Venlafaxine (Effexor)
- Zolmitriptan (Zomig)

Precautions while Using this Medicine
It is important that your doctor check your progress at regular visits. Meridia may increase blood pressure or heart rate and your doctor will check for these effects. Your doctor may need to adjust y our dose.

If Meridia does not seem to be working well, do not increase your dosage. Check with your doctor.

Do not drink excess alcohol while taking Meridia.

Notify your do ctor as soon as possible if you develop a skin rash, hives, or other allergic symptoms.

How should you take this medication?
The recommended starting dose of MERIDIA is 10-milligrams administered once daily with or without food. If there is inadequate weight loss, the dose may be titrated after 4 weeks to a total of 15-mill igrams taken once daily. The 5-milligram dose should be reserved for those patients that do not tolerate the 10-milligram dose. Blood pressure and heart rate changes should betaken into consideration when making decisions regarding dose titration. Take this medication as prescribed. Do not take it more often or longer than directed. Use in combination with other appetite suppressant medicine is ge nerally not recommended.