This medicine is a serotonin and norepinephrine reuptake inhibitor (SNRI) used to treat depression, generalized or social anxiety disorder, or panic disorder. It may also be used to treat other conditions as determined by your doctor.
Follow the directions for using this medicine provided by your doctor. THIS MEDICINE COMES WITH A MEDICATION GUIDE. Read it carefully. Ask your doctor, nurse, or pharmacist any questions that you may have about this medicine. TAKE THIS MEDICINE with food. SWALLOW WHOLE. Do not crush, break, chew, or place the medicine in water. If you have difficulty swallowing this medicine whole, the capsule may be opened and the contents sprinkled onto a spoonful of applesauce and taken as directed. Do not chew the food/medicine mixture. Swallow the mixture immediately. Take this medicine with a full glass of water (8oz/240mL). DO NOT SUDDENLY STOP TAKING THIS MEDICINE without first checking with your doctor. Side effects, including loss of coordination or balance, mental or mood changes, numbness or tingling of the skin, dizziness, drowsiness, confusion, headache, increased sweating, flu-like symptoms, nausea, ringing in the ears, seizures, tremor, trouble sleeping, or unusual tiredness may occur. STORE THIS MEDICINE at room temperature between 68 and 77 degrees F (20 and 25 degrees C), away from heat and light. Taking this medicine at the same time each day will help you to remember. CONTINUE TO TAKE THIS MEDICINE even if you feel better. Do not miss any doses. IF YOU MISS A DOSE OF THIS MEDICINE, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.
WARNING: ANTIDEPRESSANTS MAY INCREASE THE RISK OF SUICIDAL THOUGHTS OR ACTIONS in children, teenagers, and young adults. However, depression and certain other mental problems may also increase the risk of suicide. Talk with the patient's doctor to be sure that the benefits of using this medicine outweigh the risks. Family and caregivers must closely watch patients who take this medicine. It is important to keep in close contact with the patient's doctor. Tell the doctor right away if the patient has symptoms like worsened depression, suicidal thoughts, or changes in behavior. Discuss any questions with the patient's doctor. Some medicines or medical conditions may interact with this medicine. INFORM YOUR DOCTOR OR PHARMACIST of all prescription and over-the-counter medicine that you are taking. DO NOT TAKE THIS MEDICINE if you are taking or have taken linezolid, selegiline, St. John's wort, or a monoamine oxidase inhibitor (MAOI) (such as phenelzine) within the last 14 days. DO NOT TAKE THIS MEDICINE if you are also taking a fenfluramine derivative (such as dexfenfluramine), nefazodone, sibutramine, or tryptophan. ADDITIONAL MONITORING OF YOUR DOSE OR CONDITION may be needed if you are taking anticoagulants (such as warfarin), aspirin, certain diet medicines (such as phentermine), lithium, metoclopramide, rasagiline, serotonin specific reuptake inhibitors (SSRIs) (such as fluoxetine), serotonin and norepinephrine reuptake inhibitors (SNRIs) (such as duloxetine), 5-HT1 receptor agonists (such as sumatriptan), tramadol, trazodone, tricyclic antidepressants (such as amitriptyline), nonsteroidal anti-inflammatory agents (NSAIDs) (such as ibuprofen), diuretics (such as furosemide or hydrochlorothiazide), cimetidine, ketoconazole, cyproheptadine, aripiprazole, haloperidol, phenothiazines (such as chlorpromazine or thioridazine), risperidone, or a medicine that contains methylene blue. DO NOT START OR STOP any medicine without doctor or pharmacist approval. TELL YOUR DOCTOR if you will be having electroconvulsive therapy (ECT). Inform your doctor of any other medical conditions, including dehydration, low blood sodium levels, alcohol use, or a history of seizures, heart problems (such as heart failure, irregular heartbeat), abnormal ECG, recent heart attack, high blood pressure, overactive thyroid, liver or kidney problems, lung problems, stomach or bowel bleeding, blood or bleeding problems, increased eye pressure (such as glaucoma), nervous system problems, metabolism problems, allergies, pregnancy, or breast-feeding. Inform your doctor if you or a family member have a history of bipolar disorder (manic depression), other mental or mood problems, suicidal thoughts or attempts, or alcohol or substance abuse. Contact your doctor or pharmacist if you have any questions or concerns about taking this medicine.
SIDE EFFECTS that may occur while taking this medicine include abnormal dreams, blurred vision, changes in taste, constipation, decreased sexual desire or ability, dizziness, drowsiness, dry mouth, flushing, headache, increased sweating, loss of appetite, nausea, nervousness, stomach upset, trouble sleeping, vomiting, weakness, weight loss, or yawning. If they continue or are bothersome, check with your doctor. CHECK WITH YOUR DOCTOR AS SOON AS POSSIBLE if you experience fever, chills, or persistent sore throat; unsteadiness; loss of coordination; trouble concentrating; vision problems; ringing in the ears; or significant weight loss. CONTACT YOUR DOCTOR IMMEDIATELY if you experience bizarre behavior; blood in the stools; chest pain or discomfort; shortness of breath; severe or persistent cough; confusion; fast or irregular heartbeat; new or worsening agitation, anxiety, panic attacks, aggressiveness, impulsiveness, irritability, hostility, restlessness, or inability to sit still; red, swollen, blistered, or peeling skin; seizures; memory problems; severe or persistent nervousness or trouble sleeping; severe or persistent headache, dizziness, stomach pain, or weakness; suicidal thoughts or attempts; tremor; unusual bruising or bleeding; unusual or severe mental or mood changes; or worsening of depression. AN ALLERGIC REACTION to this medicine is unlikely, but seek immediate medical attention if it occurs. Symptoms of an allergic reaction include rash, itching, swelling, severe dizziness, or trouble breathing. If you notice any unusual effects, contact your doctor, nurse, or pharmacist. This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your healthcare provider. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of overdose may include coma; dilated pupils; fainting; fast, slow, or irregular heartbeat; muscle pain or weakness; new or worsening mental or mood problems; seizures; severe or persistent dizziness, drowsiness, or vomiting; trouble breathing; yellowing of the eyes or skin.
SEVERAL WEEKS MAY PASS before your symptoms improve. If your symptoms do not improve or if they become worse, check with your doctor. DO NOT SHARE THIS MEDICINE with others for whom it was not prescribed. DO NOT USE THIS MEDICINE for other health conditions. KEEP THIS MEDICINE out of the reach of children. IF USING THIS MEDICINE FOR AN EXTENDED PERIOD OF TIME, obtain refills before your supply runs out.