How should you use this medication?
Take this medication by mouth with a full glass of water. Follow the directions on the prescription label. Do not cut, crush, or chew this medication. Take it with food. If needed, the capsule may be carefully opened and the entire contents sprinkled on a spoonful of cool applesauce. Swallow the applesauce/pellet mixture right away without chewing and follow with a glass of water to ensure complete swallowing of the pellets. Try to take your medication at about the same time each day. 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 regarding the use of this medication in children. Special care may be needed.
What are the possible side effects of this medicine?
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
Increase in blood pressure
Loss of appetite with weight loss
Low sodium level-muscle weakness, fatigue, dizziness, headache, confusion
Serotonin syndrome-irritability, confusion, fast or irregular heartbeat, muscle stiffness, twitching muscles, sweating, high fever, seizures, 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):
Anxiety, nervousness
Change in sex drive or performance
Dizziness
Dry mouth
Excessive sweating
Nausea
Tremors or shaking
Trouble sleeping
What may interact with this medicine?
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
Desvenlafaxine
Dronedarone
Duloxetine
Levomilnacipran
Linezolid
MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate
Methylene blue (injected into a vein)
Milnacipran
Pimozide
Thioridazine This medication may also interact with the following:
Amphetamines
Aspirin and aspirin-like medications
Certain medications for depression, anxiety, or psychotic disturbances
Certain medications for migraine headaches like almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan
Certain medications for sleep
Certain medications that treat or prevent blood clots like dalteparin, enoxaparin, warfarin
Cimetidine
Clozapine
Diuretics
Fentanyl
Furazolidone
Indinavir
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) like dofetilide, ziprasidone
Procarbazine
Rasagiline
Supplements like St. John’s wort, kava kava, valerian
Tramadol
Tryptophan
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