This medicine is a tricyclic antidepressant used to treat depression. It may also be used to treat chronic pain and 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.STORE THIS MEDICINE at room temperature, away from heat and light. 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. If you take 1 dose daily at bedtime, do not take missed dose the next morning.
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 also taking astemizole or terfenadine. Do not take this medicine if you are taking or have taken linezolid or a monoamine oxidase inhibitor (eg, phenelzine) within the last 14 days. ADDITIONAL MONITORING OF YOUR DOSE OR CONDITION may be needed if you are taking carbamazepine, cimetidine, dicumarol, clonidine, fluoxetine, fluconazole, fluvoxamine, guanadrel, guanethidine, guanfacine, a macrolide antibiotic, mibefradil, paroxetine, sertraline, terbinafine, tramadol, a sympathomimetic, a phenothiazine, or methylene blue. DO NOT START OR STOP any medicine without doctor or pharmacist approval. Inform your doctor of any other medical conditions including any mental or mood disorders (such as bipolar disorder), allergies, pregnancy, or breast-feeding. USE OF THIS MEDICINE IS NOT RECOMMENDED if you have a history of glaucoma or increased pressure in the eye, enlarged prostate, problems urinating (urinary retention), or heart conditions. ADDITIONAL MONITORING OF YOUR DOSE OR CONDITION may be needed if you have a history of seizures or porphyria. 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 dry mouth, drowsiness, dizziness, headache, nausea, weakness, diarrhea, excess sweating, heartburn, unpleasant taste, weight gain, or an increased appetite especially for sweets. If they continue or are bothersome, check with your doctor. CHECK WITH YOUR DOCTOR AS SOON AS POSSIBLE if you experience constipation; blurred vision or other vision changes; eye pain; fast, slow, or irregular heartbeat; hair loss; shakiness; fainting; twitching of the face or tongue; mood swings; loss of balance; uncontrolled movements of arms and legs or stiffness; difficulty speaking and swallowing; unusual bleeding or bruising; sore throat or fever; skin rash and itching; swelling of hands, face, lips, eyes, throat, or tongue; irritability; ringing in the ears; seizures; yellowing of the skin or eyes; hallucinations; or chest pain. CONTACT YOUR DOCTOR IMMEDIATELY if you experience severe nervousness or anxiety, agitation, panic attacks, difficulty sleeping, feelings of irritability or hostility, impulsive behavior or other unusual changes in behavior, severe restlessness, worsening feelings of depression, thoughts of hurting yourself, or any other mental or mood changes. 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 other effects not listed above, 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 flushing, fast or irregular heartbeat, dry mouth, drowsiness, confusion, agitation, enlarged pupils, seizures, and loss of consciousness.
If your symptoms do not improve after taking this medicine for 4 weeks, inform 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.