Side
Effects
Nausea, drowsiness, dizziness, diarrhea, trouble sleeping, constipation, or
dry mouth may occur. If any of these effects persist or worsen, notify your
doctor promptly. Tell your doctor immediately if any of these serious side
effects occur: loss of appetite, unusual or severe mental/mood changes, increased
sweating/flushing, unusual fatigue, uncontrolled movements (tremor), decreased
interest in sex. Tell your doctor immediately if any of these unlikely but
serious side effects occur: blurred vision, changes in sexual ability, painful
and/or prolonged erection, change in amount of urine. Tell your doctor immediately
if any of these highly unlikely but very serious side effects occur: fainting,
irregular heartbeat, muscle pain, trouble swallowing, unusual swelling, seizures,
easy bruising or bleeding, tingling or numbness of the hands/feet. An allergic
reaction to this drug is unlikely, but seek immediate medical attention if
it occurs. Symptoms of an allergic reaction include: rash, itching, swelling,
severe dizziness, trouble breathing. If you notice other effects not listed
above, contact your doctor or pharmacist.
Precautions
Tell your doctor your medical history, especially of: liver problems, kidney
problems, seizures, heart problems, other mental/mood disorders (e.g., bipolar
disorder), thyroid problems, any allergies. This drug may make you dizzy
or drowsy; use caution engaging in activities requiring alertness such as
driving or using machinery. Limit alcoholic beverages. Caution is advised
when using this product in the elderly because they may be more sensitive
to the effects of the drug. This medication should be used only when clearly
needed during pregnancy. Discuss the risks and benefits with your doctor.
This drug passes into breast milk. Because of the potential risk to the infant,
breast-feeding while using this drug is not recommended. Consult your doctor
before breast-feeding.
Drug Interactions
Certain medications taken with this product could result in serious, even fatal,
drug interactions. Avoid taking MAO inhibitors (e.g., furazolidone, isocarboxazid,
linezolid, moclobemide, phenelzine, procarbazine, selegiline, tranylcypromine)
within 2 weeks, and avoid taking thioridazine within 5 weeks, before or after
treatment with this medication. Consult your doctor or pharmacist for additional
information. This drug is not recommended for use with: weight loss drugs
(e.g., sibutramine, phentermine), thioridazine, terfenadine, astemizole.
Ask your doctor or pharmacist for more details. Tell your doctor of all prescription
and nonprescription medication you may use, especially: other SSRI antidepressants
(e.g., citalopram, fluoxetine), nefazodone, trazodone, tramadol, venlafaxine, "triptan" migraine
drugs (e.g., sumatriptan, zolmitriptan), tricyclic antidepressants (e.g.,
amitriptyline, nortriptyline), cimetidine, digoxin, flecainide, propafenone,
clozapine, lithium, tryptophan, "blood thinners" (e.g., warfarin), theophylline,
herbal/natural products (e.g., melatonin, ayahuasca, St John's wort). Tell
your doctor if you take any drugs that cause drowsiness such as: medicine
for sleep, sedatives, tranquilizers, anti- anxiety drugs (e.g., diazepam),
narcotic pain relievers (e.g., codeine), psychiatric medicines (e.g., phenothiazines
such as chlorpromazine), anti-seizure drugs (e.g., carbamazepine), muscle
relaxants, certain antihistamines (e.g., diphenhydramine). Report other drugs
which affect the heart rhythm (QTc prolongation), such as: dofetilide, pimozide,
sotalol, quinidine, procainamide, sparfloxacin, "water pills" (diuretics
such as furosemide or hydrochlorothiazide). Ask your doctor or pharmacist
for more details. Do not start or stop any medicine without doctor or pharmacist
approval.
Overdose
If overdose is suspected, contact your local poison control center or emergency
room immediately. Symptoms of overdose may include: irregular heartbeat,
fainting, severe dizziness or lightheadedness.
Notes
Do not share this medication with others. Laboratory and/or medical tests may
be performed to monitor your progress.
Missed Dose
If you miss a dose, use it as soon as you remember. If it is near the time
of the next dose, skip the missed dose and resume your usual dosing schedule.
Do not double the dose to catch up.
Storage
Store at room temperature between 59 and 86 degrees F (15 and 30 degrees C)
away from light and moisture.
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