This medicine is a tricyclic antidepressant used to treat depression. 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 has a MEDICATION GUIDE approved by the U.S. Food and Drug Administration. Read it carefully. Ask your doctor, nurse, or pharmacist any questions that you may have about this medicine. This medicine may be taken on an empty stomach or with food. IF YOU ARE SWITCHING FROM FLUOXETINE TO THIS MEDICINE, you may need to discontinue fluoxetine for up to 5 weeks before starting this medicine. Ask your doctor if you have any questions. TAKING THIS MEDICINE AT BEDTIME may help reduce side effects such as daytime drowsiness. Discuss this possibility with your health care provider. AFTER YOU START USING THIS MEDICINE, several weeks may pass before you feel the full benefit. Do not take more than the recommended dose or change your dose without checking with your doctor. STORE THIS MEDICINE at room temperature between 59 and 86 degrees F (15 and 30 degrees C), in a tightly closed container, away from heat, moisture, and light. KEEP THIS MEDICINE out of the reach of children and away from pets. 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 or a monoamine oxidase inhibitor (MAOI) (eg, phenelzine) within the last 14 days. ADDITIONAL MONITORING OF YOUR DOSE OR CONDITION may be needed if you are taking abiraterone, antiarrhythmics (eg, flecainide, propafenone, quinidine), anticholinergics (eg, oxybutynin, scopolamine), anticoagulants (eg, warfarin), benzodiazepines (eg, alprazolam), carbamazepine, cimetidine, clonidine, droperidol, duloxetine, fluconazole, guanethidine, guanfacine, mibefradil, phenothiazines (eg, chlorpromazine, thioridazine), pimozide, selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine, sertraline), sympathomimetics (eg, albuterol, amphetamine, pseudoephedrine), terbinafine, or tramadol. Tell your doctor if you are taking thyroid medicine or a medicine that contains methylene blue. DO NOT START OR STOP any medicine without doctor or pharmacist approval. Inform your doctor of any other medical conditions, including a history of glaucoma or increased pressure in the eye, an enlarged prostate, kidney or liver problems, diabetes, problems urinating, stroke, heart problems (eg, fast or irregular heartbeat, heart attack), other mental or mood problems (eg, bipolar disorder, schizophrenia), seizures (eg, epilepsy), suicidal thoughts or tendencies, thyroid problems, the blood disorder porphyria, alcohol abuse, allergies, pregnancy, or breast-feeding. Tell your doctor if you drink alcohol, if someone in your family has a history of sudden death or irregular heartbeat, or if you undergoing electroshock therapy or you are scheduled to have surgery. USE OF THIS MEDICINE IS NOT RECOMMENDED if you are recovering from a heart attack. Use of this medicine in CHILDREN is not recommended. Discuss with your doctor the risks and benefits of giving this medicine to your child. Contact your doctor or pharmacist if you have any questions about taking this medicine.
SIDE EFFECTS that may occur while taking this medicine include constipation, diarrhea, dizziness, drowsiness, dry mouth, headache, loss of appetite, nausea, tiredness, trouble sleeping, vomiting, weakness, or weight changes. If they continue or are bothersome, check with your doctor. CONTACT YOUR DOCTOR IMMEDIATELY if you experience blurred vision or other vision changes; burning, numbness, or tingling; changes in sexual desire or ability; chest, jaw, or arm pain; confusion; decreased coordination; fainting; fast or irregular heartbeat; fever, chills, or sore throat; new or worsening mood or mental changes (eg, agitation, anxiety, delusions, hallucinations, panic attacks, aggressiveness, impulsiveness, irritability, hostility, exaggerated feeling of well-being); one-sided weakness; restlessness or inability to sit still; ringing in the ears; seizures; severe or persistent constipation or stomach pain; severe or persistent dizziness or headache; severe or persistent trouble sleeping; shortness of breath; slurred speech; sudden, severe nausea or vomiting; sudden, unusual sweating; suicidal thoughts or actions; symptoms of liver problems (eg, dark urine, pale stools, persistent loss of appetite, severe stomach pain, yellowing of the skin or eyes); tremor; trouble urinating; uncontrolled muscle movements (eg, twitching of the face or tongue, loss of balance, uncontrollable movements of arms or legs, trouble speaking or swallowing); or unusual bleeding or bruising. 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 of overdose may include agitation, body temperature changes, confusion, decreased coordination, enlarged pupils, fainting, fast or irregular heartbeat, hallucinations, rigid muscles, seizures, or sever dizziness or drowsiness.
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.