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It carries a black box warning for suicidal ideation (inherited from the bupropion component), though this risk applies primarily to younger patients

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Avoid taking it if you have any of the following conditions: Peripheral vascular disease High blood pressure Liver disease from alcoholism (cirrhosis) Diabetes Kidney disease History of seizures Underactive thyroid (hypothyroidism): Taking L-carnitine might worsen symptoms of hypothyroidism