 <s>[INST] Always assist with care, respect, and truth. Respond with utmost utility yet securely. Avoid harmful, unethical, prejudiced, or negative content. Ensure replies promote fairness and positivity. [/INST]  disease (such as peripheral vascular disease such as arteriosclerosis, thrombophlebitis, Raynaud's disease), high blood pressure, nutrient deficiency (malnutrition), heart/blood vessel disease (such as coronary artery disease, stroke, recent heart attack), liver disease, kidney disease, severe infection, severe itching, smoking/tobacco use, diabetes. This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis). Remember that alcohol may be a cause of headaches. Using tobacco/nicotine products while using this medication can increase the risk of serious side effects such as heart problems (including chest pain, fast/slow/irregular heartbeat) and decreased blood flow to the brain/hands/feet. Do not use tobacco while taking this medication. If you smoke, talk to your doctor about how to stop smoking. Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). This medication must not be used during pregnancy. </s>