Instructions

This medicine may be taken with or without food.

Swallow with a full glass (8 oz) of water unless your doctor gives you different instructions.

This medicine will work best if you take it at about the same time every day.

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

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 less than 2 hours to the next dose, do not take the missed dose. Return to your normal dosing schedule. Do not take 2 doses of this medicine 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.

Foods containing tyramine can interact with this medicine to cause serious side effects, including a dangerous rise in blood pressure. Talk to your doctor, pharmacist or dietitian about foods to avoid.

This medicine may cause low blood sugar. Eat regular meals and exercise as instructed by your doctor. Tell your doctor if you have symptoms of low blood sugar such as nausea, sweating, cold skin, fast heartbeat, hunger, and irritability.

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

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

Do not take the medicine more than twice during 24 hours.

Cautions

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.

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

Tell the doctor or pharmacist if you are pregnant, planning to be pregnant, or breastfeeding.

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

Always carry an ID card or wear a medical alert bracelet indicating your medical condition.

If you have had a heart attack or a stroke within the past year, talk to your doctor before using this medicine.

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.

Always refill this medicine before it runs out.

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.

• constipation
• dizziness or drowsiness
• dry mouth
• weakness

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

• agitated feeling or trouble sleeping
• anger or hostile feelings
• chest pain
• changes in memory, mood, or thinking
• confusion
• swelling of the legs, feet, and hands
• pain in the eye
• fainting
• severe or persistent headache
• fast or irregular heart beats
• high blood pressure
• unusual strong urges - such as increased need to shop, gamble, or have sex
• irritability
• sensitivity to light
• signs of liver damage (such as yellowing of eye or skin, dark urine, or unusual tiredness)
• tight or rigid muscles
• sore or stiff neck
• nervousness
• restlessness
• shakiness
• talking quickly
• suicidal thoughts
• excessive or unusual sweating
• blurring or changes of vision
• severe or persistent vomiting
• sudden or unexplained weight gain

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.