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. If it upsets your stomach, take it with food. Take your medication at regular intervals. Do not take it 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 regarding the use of this medication in children. Special care may be needed.

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 blurry vision, seeing halos around lights, vision loss
• Thoughts of suicide or self-harm, worsening mood, feelings of depression Side effects that usually do not require medical attention (report 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:

• Certain medications for fungal infections like fluconazole, itraconazole, ketoconazole, posaconazole, voriconazole
• Cisapride
• Citalopram
• 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
• Carbamazepine
• Certain medications for depression, anxiety, or psychotic disturbances
• Certain medications for migraine headache like almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan
• Certain medications for sleep
• Certain medications that treat or prevent blood clots like warfarin, enoxaparin, dalteparin
• Cimetidine
• Diuretics
• Dofetilide
• Fentanyl
• Furazolidone
• Isoniazid
• Lithium
• Metoprolol
• NSAIDs, medications for pain and inflammation, like ibuprofen or naproxen
• Other medications that prolong the QT interval (cause an abnormal heart rhythm)
• Procarbazine
• Rasagiline
• Supplements like St. John's wort, kava kava, valerian
• Tramadol
• Tryptophan
• Ziprasidone