Take this medication by mouth with a glass of water. Follow the directions on the prescription label. You can take it with or without food. Take your medication at regular intervals. Do not take your medication more often than directed. Do not stop taking this medication suddenly except upon the advice of your care team. Stopping this medication too quickly may cause serious side effects or your condition may worsen. A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time. Talk to your care team about the use of this medication in children. While this medication may be prescribed for children as young as 7 years for selected conditions, precautions do apply.

Side effects that you should report to your care team as soon as possible:

• Allergic reactions-skin rash, itching, hives, swelling of the face, lips, tongue, or throat
• Bleeding-bloody or black, tar-like stools, red or dark brown urine, vomiting blood or brown material that looks like coffee grounds, small red or purple spots on skin, unusual bleeding or bruising
• Heart rhythm changes-fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing
• Low sodium level-muscle weakness, fatigue, dizziness, headache, confusion
• Serotonin syndrome-irritability, confusion, fast or irregular heartbeat, muscle stiffness, twitching muscles, sweating, high fever, seizure, chills, vomiting, diarrhea
• Sudden eye pain or change in vision such as blurred vision, seeing halos around lights, vision loss
• Thoughts of suicide or self-harm, worsening mood Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
• Change in sex drive or performance
• Diarrhea
• Excessive sweating
• Nausea
• Tremors or shaking
• Upset stomach

Our pharmacists will check to see if this medication will cause any interactions with the information in your profile.

Do not take this medication with any of the following:

• Cisapride
• Dronedarone
• Linezolid
• MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate
• Methylene blue (injected into a vein)
• Pimozide
• Thioridazine This medication may also interact with the following:
• Alcohol
• Amphetamines
• Aspirin and aspirin-like medications
• Certain medications for depression, anxiety, or psychotic disturbances
• Certain medications for fungal infections like ketoconazole, fluconazole, posaconazole, and itraconazole
• Certain medications for irregular heart beat like flecainide, quinidine, propafenone
• Certain medications for migraine headaches like almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan
• Certain medications for sleep
• Certain medications for seizures like carbamazepine, valproic acid, phenytoin
• Certain medications that treat or prevent blood clots like warfarin, enoxaparin, dalteparin
• Cimetidine
• Digoxin
• Diuretics
• Fentanyl
• Isoniazid
• Lithium
• NSAIDs, medications for pain and inflammation, like ibuprofen or naproxen
• Other medications that prolong the QT interval (cause an abnormal heart rhythm) like dofetilide
• Rasagiline
• Safinamide
• Supplements like St. John's wort, kava kava, valerian
• Tolbutamide
• Tramadol
• Tryptophan