Common side effects include abdominal pain, loss of appetite, nausea, feeling tired, and dizziness. Serious side effects may include angioedema, liver problems, stroke, psychosis, heart problems, suicide, and aggression. A 2020 meta-analysis found that<unk>  was associated with anorexia, weight loss, and hypertension, rating it as a "potentially least preferred agent based on safety" for treating ADHD. As of 2019, safety in pregnancy and breastfeeding is not clear; a 2018 review stated that, "because of lack of data, the treating physician should consider stopping<unk>  treatment in women with ADHD during pregnancy." The U.S. Food and Drug Administration (FDA) has issued a black box warning for suicidal behavior/ideation. Similar warnings have been issued in Australia. Unlike stimulant medications,<unk>  does not have abuse liability or the potential to cause withdrawal effects on abrupt discontinuation. Incidence of adverse effects Very common (>10% incidence) adverse effects include: * Nausea (26%) * Xerostomia (Dry mouth) (20%) * Appetite loss (16%) * Insomnia (15%) * Fatigue (10%) * Headache * Cough * Vomiting (in children and adolescents) Common (1–10% incidence) adverse effects include: Uncommon (0.1–1% incidence) adverse effects include: Rare (0.01–0.1% incidence) adverse effects including: * Raynaud's phenomenon * Abnormal/increased liver function tests * Jaundice * Hepatitis * Liver injury * Acute liver failure * Urinary retention * Priapism * Male genital pain
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