This medicine is a selective serotonin reuptake inhibitor (SSRI) used to treat depression. It may also be used to treat other conditions as determined by your doctor.
Follow the directions for taking this medicine provided by your doctor. This medicine comes with a MEDICATION GUIDE approved by the U.S. Food and Drug Administration. Read it carefully each time you refill this medicine. Ask your doctor, nurse, or pharmacist any question that you may have about this medicine. TAKE THIS MEDICINE by mouth with or without food. It may take 1 to 4 weeks before you notice improvement. DO NOT STOP TAKING THIS MEDICINE or change your dose without checking with your doctor. STORE THIS MEDICINE at 77 degrees F (25 degrees C), away from heat, moisture, and light. Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Do not store in the bathroom. KEEP THIS MEDICINE out of the reach of children and away from pets. Taking this medicine at the same time each day will help you remember to take it. CONTINUE TO TAKE THIS MEDICINE even if you feel well. Do not miss any doses. DO NOT SUDDENLY STOP TAKING THIS MEDICINE without checking with your doctor. Side effects may occur. They may include mental or mood changes, numbness or tingling of the skin, dizziness, confusion, headache, trouble sleeping, or unusual tiredness. You will be closely monitored when you start this medicine and whenever a change in dose is made. 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. FAMILIES 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 certain antiarrhythmics (eg, amiodarone, procainamide, quinidine, sotalol), certain antibiotics (eg, gatifloxacin, moxifloxacin), escitalopram, a fenfluramine derivative (eg, dexfenfluramine), levomethadyl, methadone, nefazodone, pentamidine, phenothiazines (eg, chlorpromazine, thioridazine), pimozide, serotonin-norepinephrine reuptake inhibitors (SNRIs) (eg, duloxetine, venlafaxine), sibutramine, other SSRIs (eg, fluoxetine, paroxetine), or tryptophan. DO NOT TAKE THIS MEDICINE if you are taking or have taken linezolid, a monoamine oxidase inhibitor (MAOI) (eg, phenelzine, selegiline), or St. John's wort within the last 14 days. ADDITIONAL MONITORING OF YOUR DOSE OR CONDITION may be needed if you are taking antiarrhythmics (eg, propafenone), anticoagulants (eg, warfarin), aripiprazole, arsenic, aspirin, beta-blockers (eg, propranolol), carbamazepine, cimetidine, clozapine, cyproheptadine, diuretics (eg, furosemide, hydrochlorothiazide), fentanyl, halofantrine, lithium, meperidine, metoclopramide, nilotinib, nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen), omeprazole, ondansetron, risperidone, serotonin 5-HT1 receptor agonists (eg, sumatriptan), sibutramine, tramadol, trazodone, tricyclic antidepressants (eg, amitriptyline), vandetanib, or a medicine that contains methylene blue. TELL YOUR DOCTOR if you take any medicine that may increase the risk of a certain type of irregular heartbeat (prolonged QT interval). Check with your doctor or pharmacist if you are unsure if any of your medicines may increase the risk of this type of irregular heartbeat. DO NOT START OR STOP any medicine without doctor or pharmacist approval. Inform your doctor of any other medical conditions, including a history of seizures, liver problems, kidney problems, heart problems (eg, heart failure, slow or irregular heartbeat), high blood pressure, stroke, bleeding problems, stomach or bowel bleeding, metabolism problems, allergies, pregnancy, or breast-feeding. Tell your doctor if you or a family member has a history of bipolar disorder (manic-depression), other mental or mood problems, suicidal thoughts or attempts, or alcohol or substance abuse. Tell your doctor if you are dehydrated, have low blood volume or low blood sodium levels, drink alcohol, or will be having electroconvulsive therapy (ECT). Tell your doctor if you have a condition or take medicine that may increase your risk for low potassium or magnesium levels. Check with your doctor if you are not sure if any of your conditions or medicines may increase this risk. USE OF THIS MEDICINE IS NOT RECOMMENDED if you have a certain type of irregular heartbeat (long QT syndrome), slow heartbeat, severe heart failure, a recent heart attack, or uncorrected low blood potassium or magnesium levels, unless your doctor tells you otherwise. Contact your doctor or pharmacist if you have any questions or concerns about using this medicine.
SIDE EFFECTS that may occur while taking this medicine include constipation; decreased sexual desire or ability; diarrhea; dizziness; drowsiness; dry mouth; increased sweating; loss of appetite; nausea; stuffy nose; tiredness; weakness; or yawning. If they continue or are bothersome, check with your doctor. THIS MEDICINE MAY CAUSE an increased risk of a certain type of severe irregular heartbeat (QT prolongation). The risk may be higher with high doses of this medicine. It may also be higher if you have a certain type of irregular heartbeat (long QT syndrome) or low blood potassium or magnesium levels. Tell your doctor right away if you develop chest pain; fast, slow, or irregular heartbeat; shortness of breath; dizziness; or fainting. Discuss any questions or concerns with your doctor. CONTACT YOUR DOCTOR IMMEDIATELY if you experience absent menstrual period; bizarre behavior; black or bloody stools; confusion; decreased concentration; decreased coordination; hallucinations; memory loss; new or worsening agitation, panic attacks, aggressiveness, impulsiveness, irritability, hostility, exaggerated feeling of well-being, restlessness, or inability to sit still; persistent, painful erection; red, swollen, blistered, or peeling skin; seizures; severe or persistent anxiety or trouble sleeping; severe or persistent headache or dizziness; stomach pain; suicidal thoughts or attempts; tremor; unusual bruising or bleeding; unusual or severe mental or mood changes; unusual weakness; vision 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; hives; itching; difficulty breathing; tightness in the chest; or swelling of the mouth, face, lips, or tongue. This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care 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 may include blue skin or lips; coma; confusion; fast breathing; fast, slow, or irregular heartbeat; memory loss; muscle pain; seizures; severe or persistent dizziness, drowsiness, nausea, or vomiting; or tremor.
DO NOT SHARE THIS MEDICINE with others for whom it was not prescribed. DO NOT USE THIS MEDICINE for other health conditions. IF YOU WILL BE USING THIS MEDICINE FOR AN EXTENDED PERIOD OF TIME, be sure to obtain necessary refills before your supply runs out. CHECK WITH YOUR PHARMACIST about how to dispose of unused medicine.