Instructions

Swallow the medicine without crushing or chewing it.

This medicine may be taken with or without food.

To relieve dry mouth, chew gum, suck on hard candy/ice chips, drink extra water, or use a saliva substitute.

Store at room temperature away from heat, light, and moisture. Do not keep in the bathroom.

To reduce constipation, eat high fiber foods, drink plenty of water and exercise.

Tell your doctor if you have severe or persistent sweating, diarrhea or vomiting. These can increase your risk of a serious side effect.

This medicine can make you sensitive to the sun. Use sunscreen or protective clothing when in sun.

It may take several weeks for this medicine to fully work.

It is important that you keep taking each dose of this medicine on time even if you are feeling well.

If you forget to take a dose on time, take it as soon as you remember. If it is almost time for the next dose, do not take the missed dose. Return to your normal schedule. Do not take 2 doses at one time.

Drug interactions can change how medicines work or increase risk for side effects. Tell your health care providers about all medicines taken. Include prescription and over-the-counter medicines, vitamins, and herbal medicines. Speak with your doctor or pharmacist before starting or stopping any medicine.

Tell your doctor if symptoms do not get better or if they get worse.

If you need to stop this medicine, your doctor may wish to gradually reduce the dosage before stopping.

This medicine may affect your blood sugar levels. If you have diabetes, talk to your doctor before changing the dose of your diabetes medicine.

Keep all appointments for medical exams and tests while on this medicine.

Cautions

This medicine may rarely cause a very serious condition called serotonin syndrome/toxicity. Get medical help right away if you have a fast heartbeat, hallucinations, muscle trembling, or restlessness.

Tell your doctor and pharmacist if you ever had an allergic reaction to a medicine.

Do not use the medication any more than instructed.

This medicine may cause dizziness or fainting. Do not stand or sit up quickly.

If possible, avoid using with alcohol, marijuana, or other medicines that can cause dizziness or drowsiness. These include allergy/cold products, muscle relaxers, sleep aids, and pain relievers.

Your ability to stay alert or to react quickly may be impaired by this medicine. Do not drive or operate machinery until you know how this medicine will affect you.

Smoking may affect the level of this medicine in your body. Tell your doctor if you smoke, or stop smoking while on this medicine.

Avoid becoming overheated during exercise or other activities. Try to stay cool in hot weather.

Family should check on the patient often. Call the doctor if patient becomes more depressed, has thoughts of suicide, or shows changes in behavior.

This medicine passes into breast milk. Ask your doctor before breastfeeding.

During pregnancy, this medicine should be used only when clearly needed. Talk to your doctor about the risks and benefits.

Do not take St. John's wort while on this medicine.

If you have a painful erection or an erection for more than 4 hours, seek medical care right away.

Do not share this medicine with anyone who has not been prescribed this medicine.

Some patients have serious side effects from this medicine. Ask your pharmacist to show you the information from the Food and Drug Administration (FDA) and discuss it with you.

Side Effects

The following is a list of some common side effects from this medicine. Please speak with your doctor about what you should do if you experience these or other side effects.

• agitated feeling or trouble sleeping
• increased appetite
• constipation or diarrhea
• dizziness or drowsiness
• lightheadedness
• weight gain

Call your doctor or get medical help right away if you notice any of these more serious side effects:

• bleeding or bruising
• breast milk
• breast pain or swelling
• breathing interruption during sleep
• difficulty concentrating
• confusion
• coughing up blood or vomit that looks like coffee grounds
• swelling of the legs, feet, and hands
• pain in the eye
• hallucinations (unusual thoughts, seeing or hearing things that are not real)
• severe or persistent headache
• fast, irregular, or slow heartbeat
• signs of kidney damage (such as change in urine color or bubbly urine)
• signs of liver damage (such as yellowing of eye or skin, dark urine, or unusual tiredness)
• menstruation changes (missed or fewer periods)
• uncontrollable movement of face, tongue, arms or legs
• muscle aches, spasms or abnormal movements
• muscle trembling
• restlessness
• seizures
• problems with sexual functions or desire
• shortness of breath
• bloody or dark, tarry stools
• suicidal thoughts
• excessive thirst
• increased urinary frequency
• difficulty or discomfort urinating
• blurring or changes of vision
• seeing halos or colors around lights

A few people may have an allergic reaction to this medicine. Symptoms can include difficulty breathing, skin rash, itching, swelling, or severe dizziness. If you notice any of these symptoms, seek medical help quickly.