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Simple, supportive mental health care on your terms, including access to prescription medication when appropriate.

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Prescription
mental health support on your time

When you are struggling with your mental health, waiting weeks for treatment is not an option. LifeMD connects you with a licensed provider for a timely evaluation, medication, and expert support.

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Escitalopram

Lexapro®

Delivered

Wellbutrin SR®

Bupropion SR

Delivered

Dr. Anthony Puopolo

Hi. Following up to see if you’re feeling better. You got this!

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Available In All 50 States
745,000 Patients
100% Online Virtual Care
4.9 Star App Store Rating
4.9 Star Google Play Store Rating
Board-Certified Providers
Available In All 50 States
745,000 Patients
100% Online Virtual Care

Access affordable mental health
medications and expert care

Prescription medication can be an incredible tool when addressing mental health challenges.
Our knowledgeable healthcare providers will work with you to find a treatment
that helps you feel and function better.

Social &
Performance Anxiety

Relief

Designed for as-needed treatment. The plan includes an initial review of your health information and secure messaging with your provider, ongoing message-based support, and a set amount of medication each month if prescribed.

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Anxiety &
Depression

Balance

Ideal for managing ongoing anxiety or depression. This plan includes an initial video visit with a provider, the option for ongoing support through secure messaging, and includes a 30-day supply of medication if prescribed.

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We believe quality care should be accessible to everyone. The LifeMD Mental Health Program
offers options that are fast, affordable, and easy to start.

Virtual mental healthcare
when you need it

Get timely psychiatric care when you need it
Avoid inconvenient office visits and waiting rooms
Speak with U.S-licensed healthcare providers
Access affordable, science-backed medications

Get prescription medications
online through LifeMD

Manage a range of mental health conditions, including anxiety and depression — right from home.
Treatment includes medication, if prescribed, and ongoing support.

Wellbutrin SR®
Lexapro®
Prozac®
Inderal®
Buspar®
Celexa®
Cymbalta®
Effexor®
Zoloft®
150mg
Tablet
Generic available

Wellbutrin SR®

Get Started Get Started
10mg
Tablet
Generic available

Lexapro®

Get Started Get Started
10mg-20mg
Capsule
Generic available

Prozac®

Get Started Get Started
40mg
Tablet
Generic available

Inderal®

Get Started Get Started
15mg
Tablet
Generic available

Buspar®

Get Started Get Started
20mg
Tablet
Generic available

Celexa®

Get Started Get Started
30mg
Capsule
Generic available

Cymbalta®

Get Started Get Started
37.5mg-75mg
Tablet
Generic available

Effexor®

Get Started Get Started
50mg-100mg
Tablet
Generic available

Zoloft®

Get Started Get Started
Wellbutrin SR®
150mg
Tablet
Generic available

Wellbutrin SR®

Get Started Get Started
Lexapro®
10mg
Tablet
Generic available

Lexapro®

Get Started Get Started
Prozac®
10mg-20mg
Capsule
Generic available

Prozac®

Get Started Get Started
Inderal®
40mg
Tablet
Generic available

Inderal®

Get Started Get Started
Buspar®
15mg
Tablet
Generic available

Buspar®

Get Started Get Started
Celexa®
20mg
Tablet
Generic available

Celexa®

Get Started Get Started
Cymbalta®
30mg
Capsule
Generic available

Cymbalta®

Get Started Get Started
Effexor®
37.5mg-75mg
Tablet
Generic available

Effexor®

Get Started Get Started
Zoloft®
50mg-100mg
Tablet
Generic available

Zoloft®

Get Started Get Started

How it Works

Begin treatment online in just 3 easy steps.

01
Start your consultation

Answer a few questions about your health history and current symptoms. It only takes a few minutes.

02
Connect with a provider

A licensed provider will carefully review your responses and, if appropriate, prescribe a personalized treatment plan.

03
Begin a treatment plan

Your provider will create a personalized plan, which may include prescription medication and ongoing support.

Get Started Today Get Started Today

Mild anxiety

What this might feel like

Feeling anxious or on edge

Thoughts that won’t stop

Worrying more than usual

Anxious in social settings

Generally feeling anxious

Anxious during meetings

Treatments for mental health

Get comprehensive mental health support when and where you need it. Whether you’re facing
anxiety, depression, or other challenges, LifeMD offers personalized care to help you feel better on
your time.

Treatment

Social
anxiety

Learn More

Treatment

Performance
anxiety

Learn More

Treatment

General
anxiety

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Treatment

Insomnia

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Treatment

Depression

Learn More

Treatment

PTSD

Learn More

Treatment

Restlessness

Learn More

Clear pricing. Zero surprises.

Your front door to healthcare — unlimited virtual care access, exclusive
pricing, and wellness tools that fit your lifestyle.

Mental Health

Taking care of your mental health is easier and more affordable than ever. LifeMD offers video- and message-based consults, expert diagnoses, and medication, when appropriate.

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Virtual psychiatric evaluations
Diagnosis and treatment for anxiety and depression
Medication management when appropriate
Ongoing support from licensed providers

LifeMD

You now have unlimited access to your care team.

10:05 AM

How LifeMD, psychiatric care,
and medication work together

Mental health care through LifeMD is convenient and affordable — with no outside
referrals needed.

Mental Health

Mental health medication can help balance brain chemistry, manage symptoms, and support your overall well-being, making it easier to navigate daily life and emotional challenges.

Psychiatry Care

Schedule a video consultation at your convenience or get an initial response within hours if message-based care is recommended.

Prescription Medication

Prescription delivered hassle-free to your preferred address or same-day pickup at a local pharmacy.

Frequently Asked Questions

What is the LifeMD Mental Health Program?

The LifeMD Mental Health Program provides virtual, medication-based support for anxiety and depression. Care is personalized and accessible from home.

What conditions does the program treat?

LifeMD treats performance anxiety, social anxiety, generalized anxiety disorder, and depression through provider-guided medication management.

What's included in the LifeMD Mental Health Program?

The program includes provider consultations, personalized treatment, secure messaging, prescription management, and the cost of medication when prescribed.

How is my treatment plan personalized?

Every treatment plan is designed based on your symptoms, history, goals, and preferences.

What medications may be prescribed?

Depending on your condition and care plan, your provider may prescribe medications like SSRIs, SNRIs, and NDRIs. In addition, where appropriate, medications such as beta blockers may be prescribed "off-label" for certain mental health conditions.

Do I need a video visit to receive treatment?

Some patients begin with a video consult, while others may qualify for message-based care depending on their condition and medical history.

What happens after I start treatment?

After starting treatment, you'll check in regularly so your provider can review your progress and make adjustments if needed.

Who will manage my care at LifeMD?

You'll work with a licensed medical provider who will design and adjust your treatment plan based on your symptoms and goals.

How often will my plan be reviewed?

Treatment plans are reviewed monthly through brief renewal check-ins to monitor symptoms, side effects, and treatment effectiveness.

Will I be able to message my provider?

Yes. You'll have secure messaging access to your provider so you can ask questions or share updates at any time.

What if I have questions between appointments?

You can securely message your provider anytime through the patient portal with questions or concerns.

How do refills work?

Your provider will send refill reminders and request check-ins to assess your response before renewing medications each month.

Will my dosage change over time?

It depends. Your provider may adjust your dosage based on monthly check-ins and symptom tracking.

Is everything handled online?

Yes. All care, from consultations to prescription delivery, is handled online for convenience, privacy, and flexibility.

Clinically proven psychiatry treatments

LifeMD offers comprehensive, personalized care through psychiatry services and medication. Our secure virtual platform makes accessing quality mental health care “no big deal”.

Get Started Today Get Started Today

Important Notice: Talk to your psychiatrist or healthcare professional about the possible risks and benefits associated with the above medications before starting treatment. LifeMD does not offer therapy or counseling services and is not equipped to respond to mental health emergencies. If you’re experiencing a crisis, please call 911 or visit the nearest emergency room. IF YOU ARE CONTEMPLATING SUICIDE, CONTACT 911 OR CALL/TEXT THE NATIONAL SUICIDE PREVENTION LINE AT 988. These services are available 24/7.

Propranolol

Next refill: May 21

Prescribed

Wellbutrin SR®

Next refill: May 21

Prescribed

Zoloft®

Next refill: May 21

Prescribed

Important Safety Information

Last Updated: June 28, 2025
Table of Contents
  1. Bupropion SR (Wellbutrin SR®)
  2. Buspirone HCI (Buspar)
  3. Citalopram (Celexa®)
  4. Duloxetine (Cymbalta®)
  5. Escitalopram (Lexapro®)
  6. Fluoxetine (Prozac®)
  7. Paroxetine (Paxil®)
  8. Propranolol (Inderal®)
  9. Sertraline (Zoloft®)
  10. Venlafaxine (Effexor®)
 

Warning
○ Drugs like this one have raised the chance of suicidal thoughts or actions in children and young adults. The risk may be greater in people who have had these thoughts or actions in the past. All people who take this drug need to be watched closely. Call the doctor right away if signs like depression, nervousness, restlessness, grouchiness, panic attacks, or changes in mood or actions are new or worse. Call the doctor right away if any thoughts or actions of suicide occur.


What is this drug used for?

  • It is used to treat depression.
  • It is used to prevent seasonal affective disorder (SAD).
  • It is used to help stop smoking.
  • It may be given to you for other reasons. Talk with the doctor.

What do I need to tell my doctor BEFORE I take this drug?

  • If you are allergic to this drug; any part of this drug; or any other drugs, foods, or
  • If you have ever had seizures.
  • If you drink a lot of alcohol and you stop drinking all of a sudden.
  • If you use certain other drugs like drugs for seizures or anxiety and you stop using
  • If you have ever had an eating problem like anorexia or bulimia.
  • If you have any of these health problems: Kidney disease or liver disease.
  • If you have taken certain drugs for depression or Parkinson's disease in the last 14
  • If you are taking any of these drugs: Clopidogrel, linezolid, methylene blue, or
  • If you are taking another drug that has the same drug in it.

This is not a list of all drugs or health problems that interact with this drug.
Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take this drug?
For all patients taking this drug:

  • Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
  • Avoid driving and doing other tasks or actions that call for you to be alert or have clear eyesight until you see how this drug affects you.
  • This drug may affect certain lab tests. Tell all of your health care providers and lab workers that you take this drug.
  • Do not stop taking this drug all of a sudden without calling your doctor. You may have a greater risk of side effects. If you need to stop this drug, you will want to slowly stop it as ordered by your doctor.
  • High blood pressure has happened with this drug. Have your blood pressure checked as you have been told by your doctor.
  • This drug may raise the chance of seizures. The risk may be higher in people who take higher doses, have certain health problems, or take certain other drugs. People who suddenly stop drinking a lot of alcohol or suddenly stop taking certain drugs (like drugs used for anxiety, sleep, or seizures) may also have a higher risk. Talk to your doctor to see if you have a greater chance of seizures.
  • Avoid drinking alcohol while taking this drug.
  • Talk with your doctor before you use marijuana, other forms of cannabis, or prescription or OTC drugs that may slow your actions.
  • It may take several weeks to see the full effects.
  • This drug is not approved for use in children. Talk with the doctor.
  • If you are 65 or older , use this drug with care. You could have more side effects.
  • Tell your doctor if you are pregnant, plan on getting pregnant, or are breast-feeding.

You will need to talk about the benefits and risks to you and the baby.
If you smoke:

  • Not all products are approved for use to help stop smoking. Talk with the doctor to make sure that you have the right product.
  • New or worse mental, mood, or behavior problems have happened when bupropion has been used to stop smoking. These problems include thoughts of suicide or murder , depression, forceful actions, fury, anxiety, and anger. These problems have happened in people with and without a history of mental or mood problems. Talk with the doctor.

What are some side effects that I need to call my doctor about right away? WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Signs of high blood pressure like very bad headache or dizziness, passing out, or change in eyesight.
  • Feeling confused, not able to focus, or change in behavior.
  • Hallucinations (seeing or hearing things that are not there).
  • If seizures are new or worse after starting this drug.
  • Chest pain or pressure, a fast heartbeat, or an abnormal heartbeat.
  • Swelling.
  • Shortness of breath.
  • Change in hearing.
  • Ringing in ears.
  • Passing urine more often.
  • Swollen gland.
  • Trouble moving around.
  • Some people may have a higher chance of eye problems with this drug. Your doctor may want you to have an eye exam to see if you have a higher chance of these eye problems. Call your doctor right away if you have eye pain, change in eyesight, or swelling or redness in or around the eye.
  • A severe skin reaction (Stevens-Johnson syndrome) may happen. It can cause severe health problems that may not go away, and sometimes death. Get medical help right away if you have signs like red, swollen, blistered, or peeling skin (with or without fever); red or irritated eyes; or sores in your mouth, throat, nose, or eyes.

What are some other side effects of this drug?

All drugs may cause side effects. However , many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:
All products:

  • Dizziness or headache.
  • Constipation, diarrhea, stomach pain, upset stomach, throwing up, or decreased
  • Shakiness.
  • Feeling nervous and excitable.
  • Strange or odd dreams.
  • Gas.
  • Dry mouth.
  • Trouble sleeping.
  • Muscle or joint pain.
  • Nose or throat irritation.
  • Sweating a lot.
  • A change in weight without trying.

Extended-release tablets:

  • For some brands, you may see the tablet shell in your stool. For these brands, this is normal and not a cause for concern. If you have questions, talk with your doctor. These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects. You may report side effects to your national health agency.

How is this drug best taken?

Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.

For all uses of this drug:

  • Do not take this drug more often than you are told. This may raise the risk of seizures. Be sure you know how far apart to take your doses.
  • Take in the morning if taking once a day.
  • Take with or without food.
  • If you are not able to sleep, do not take this drug too close to bedtime. Talk with your doctor.
  • Swallow whole. Do not chew, break, or crush.
  • Keep taking this drug as you have been told by your doctor or other health care provider , even if you feel well.
  • If you have trouble swallowing, talk with your doctor. For stopping smoking:
  • You may take this drug for 1 week before you stop smoking.
  • Nicotine products and counseling may be used at the same time for best results.
  • If you have not been able to quit smoking after taking this drug for 12 weeks, talk with your doctor.
  • You may have signs of nicotine withdrawal when you try to quit smoking even when using drugs like this one to help you quit smoking. There are many signs of nicotine withdrawal. Rarely depression and suicidal thoughts have happened in people trying to quit smoking. Talk with your doctor.

What do I do if I miss a dose?

  • Skip the missed dose and go back to your normal time.
  • Do not take 2 doses at the same time or extra doses.

How do I store and/or throw out this drug?

  • Store at room temperature protected from light. Store in a dry place. Do not store in a bathroom.
  • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
  • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

General drug facts

  • If your symptoms or health problems do not get better or if they become worse, call your doctor.
  • Do not share your drugs with others and do not take anyone else's drugs.
  • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor , nurse, pharmacist, or other health care provider.
  • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.
 

What is this drug used for?

  • It is used to treat anxiety.
  • It may be given to you for other reasons. Talk with the doctor.

What do I need to tell my doctor BEFORE I take this drug?

  • If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
  • If you have taken certain drugs for depression or Parkinson's disease in the last 14 days. This includes isocarboxazid, phenelzine, tranylcypromine, selegiline, or rasagiline. Very high blood pressure may happen.
  • If you are taking any of these drugs: Linezolid or methylene blue.+
  • If you are taking tryptophan.
  • If you have any of these health problems: Kidney disease or liver disease.

This is not a list of all drugs or health problems that interact with this drug. Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take this drug?

  • Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
  • Avoid driving and doing other tasks or actions that call for you to be alert until you see how this drug affects you.
  • Avoid drinking alcohol while taking this drug.
  • Talk with your doctor before you use marijuana, other forms of cannabis, or prescription or OTC drugs that may slow your actions.
  • If you drink grapefruit juice or eat grapefruit often, talk with your doctor.
  • This drug may affect certain lab tests. Tell all of your health care providers and lab workers that you take this drug.
  • Tell your doctor if you are pregnant, plan on getting pregnant, or are breast-feeding. You will need to talk about the benefits and risks to you and the baby.

What are some side effects that I need to call my doctor about right away?
WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Restlessness.
  • Trouble controlling body movements, twitching, change in balance, trouble swallowing or speaking.
  • A severe and sometimes deadly problem called serotonin syndrome may happen. The risk may be greater if you also take certain other drugs. Call your doctor right away if you have agitation; change in balance; confusion; hallucinations; fever; fast or abnormal heartbeat; flushing; muscle twitching or stiffness; seizures; shivering or shaking; sweating a lot; severe diarrhea, upset stomach, or throwing up; or very bad headache.

    • What are some other side effects of this drug?

      All drugs may cause side effects. However , many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:
    • Feeling dizzy or sleepy.
    • Feeling nervous and excitable.
    • Headache.
    • Upset stomach.

    These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects. You may report side effects to your national health agency.

    How is this drug best taken?

      Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.
    • Take with or without food but take the same way each time. Always take with food or always take on an empty stomach.
    • Keep taking this drug as you have been told by your doctor or other health care provider , even if you feel well.
    • Some tablets may have a score line. If needed, these tablets may be split on the score line.

    What do I do if I miss a dose?

    • Take a missed dose as soon as you think about it.
    • If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
    • Do not take 2 doses at the same time or extra doses.

    How do I store and/or throw out this drug?

    • Store at room temperature in a dry place. Do not store in a bathroom.
    • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
    • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

    General drug facts

    • If your symptoms or health problems do not get better or if they become worse, call your doctor.
    • Do not share your drugs with others and do not take anyone else's drugs.
    • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor , nurse, pharmacist, or other health care provider.
    • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.
     
    Warning
    For all patients taking this drug:
    • Drugs like this one have raised the chance of suicidal thoughts or actions in children and young adults. The risk may be greater in people who have had these thoughts or actions in the past. All people who take this drug need to be watched closely. Call the doctor right away if signs like depression, nervousness, restlessness, grouchiness, panic attacks, or changes in mood or actions are new or worse. Call the doctor right away if any thoughts or actions of suicide occur.

    Children:

    • This drug is not approved for use in children. However , the doctor may decide the benefits of taking this drug outweigh the risks. If your child has been given this drug, ask the doctor for information about the benefits and risks. Talk with the doctor if you have questions about giving this drug to your child.

    What is this drug used for?

    • It is used to treat depression.
    • It may be given to you for other reasons. Talk with the doctor.

    What do I need to tell my doctor BEFORE I take this drug?

    • If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
    • If you have any of these health problems: Long QTc on ECG or other heartbeat that is not normal, slow heartbeat, or low potassium or magnesium levels.
    • If you have any of these health problems: Heart failure (weak heart) or a recent heart attack.
    • If you are taking any of these drugs: Linezolid or methylene blue.
    • If you are taking any of these drugs: Escitalopram or pimozide.
    • If you are taking any drugs that can cause a certain type of heartbeat that is not normal (prolonged QT interval). There are many drugs that can do this. Ask your doctor or pharmacist if you are not sure.
    • If you have taken certain drugs for depression or Parkinson's disease in the last 14 days. This includes isocarboxazid, phenelzine, tranylcypromine, selegiline, or rasagiline. Very high blood pressure may happen.

    This is not a list of all drugs or health problems that interact with this drug. Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.


    What are some things I need to know or do while I take this drug?
    For all patients taking this drug:

    • Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
    • Avoid driving and doing other tasks or actions that call for you to be alert until you see how this drug affects you.
    • Do not stop taking this drug all of a sudden without calling your doctor. You may have a greater risk of side effects. If you need to stop this drug, you will want to slowly stop it as ordered by your doctor.
    • An unsafe heartbeat that is not normal (long QT on ECG) has happened with this drug. Sudden deaths have rarely happened in people taking this drug. Talk with the doctor.
    • Avoid drinking alcohol while taking this drug.
    • Talk with your doctor before you use marijuana, other forms of cannabis, or prescription or OTC drugs that may slow your actions.
    • In depression, sleep and appetite may get better soon after starting this drug. Other depression signs may take up to 4 weeks to get better.
    • This drug may raise the chance of bleeding. Sometimes, bleeding can be life- threatening. Talk with the doctor.
    • Some people may have a higher chance of eye problems with this drug. Your doctor may want you to have an eye exam to see if you have a higher chance of these eye problems. Call your doctor right away if you have eye pain, change in eyesight, or swelling or redness in or around the eye.
    • This drug can cause low sodium levels. Very low sodium levels can be life-threatening, leading to seizures, passing out, trouble breathing, or death.
    • If you are 60 or older , use this drug with care. You could have more side effects.
    • Tell your doctor if you are pregnant, may be pregnant, or plan to get pregnant while taking this drug. You will need to talk about the benefits and risks to you and the baby. Taking this drug in the third trimester of pregnancy may raise your risk of bleeding after delivery and may lead to some health problems in the newborn.
    • Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.

    Children:

    • This drug may affect growth in children and teens in some cases. They may need regular growth checks. Talk with the doctor.

    What are some side effects that I need to call my doctor about right away?
    WARNING/CAUTION:     Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

    • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
    • Signs of low sodium levels like headache, trouble focusing, memory problems, feeling confused, weakness, seizures, or change in balance.
    • Signs of bleeding like throwing up or coughing up blood; vomit that looks like coffee grounds; blood in the urine; black, red, or tarry stools; bleeding from the gums; abnormal vaginal bleeding; bruises without a cause or that get bigger; or bleeding you cannot stop.
    • Chest pain or pressure.
    • Fast, slow, or abnormal heartbeat.
    • Shortness of breath.
    • Dizziness or passing out.
    • Seizures.
    • A change in weight without trying.
    • Painful erection (hard penis) or an erection that lasts for longer than 4 hours.
    • Period (menstrual) changes.
    • Sex problems have happened with drugs like this one. This includes lowered interest in sex, trouble having an orgasm, ejaculation problems, or trouble getting or keeping an erection. If you have any questions, talk with your doctor.
    • A severe and sometimes deadly problem called serotonin syndrome may happen. The risk may be greater if you also take certain other drugs. Call your doctor right away if you have agitation; change in balance; confusion; hallucinations; fever; fast or abnormal heartbeat; flushing; muscle twitching or stiffness; seizures; shivering or shaking; sweating a lot; severe diarrhea, upset stomach, or throwing up; or very bad headache.

    What are some other side effects of this drug?

      All drugs may cause side effects. However , many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:
    • Feeling dizzy, sleepy, tired, or weak.
    • Dry mouth.
    • Constipation, diarrhea, upset stomach, throwing up, or decreased appetite.
    • Trouble sleeping.
    • Shakiness.
    • Sweating a lot.
    • Yawning.
    • Signs of a common cold. These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects. You may report side effects to your national health agency.

    How is this drug best taken?

    Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.

    All products:

    • Take with or without food.
    • Keep taking this drug as you have been told by your doctor or other health care provider , even if you feel well.

    Oral solution:

    • Measure liquid doses carefully. Use the measuring device that comes with this drug. If there is none, ask the pharmacist for a device to measure this drug.

    What do I do if I miss a dose?

    • Take a missed dose as soon as you think about it.
    • If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
    • Do not take 2 doses at the same time or extra doses.

    How do I store and/or throw out this drug?

    • Store at room temperature in a dry place. Do not store in a bathroom.
    • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
    • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

    General drug facts

    • If your symptoms or health problems do not get better or if they become worse, call your doctor.
    • Do not share your drugs with others and do not take anyone else's drugs.
    • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor , nurse, pharmacist, or other health care provider.
    • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.
     

    Warning

    • Drugs like this one have raised the chance of suicidal thoughts or actions in children and young adults. The risk may be greater in people who have had these thoughts or actions in the past. All people who take this drug need to be watched closely. Call the doctor right away if signs like depression, nervousness, restlessness, grouchiness, panic attacks, or changes in mood or actions are new or worse. Call the doctor right away if any thoughts or actions of suicide occur.

    What is this drug used for?

    • It is used to treat depression.
    • It is used to treat anxiety.
    • It is used to help painful nerve diseases and diabetic nerve problems.
    • It is used to ease long-term pain problems.
    • It is used to treat fibromyalgia.
    • It may be given to you for other reasons. Talk with the doctor.

    What do I need to tell my doctor BEFORE I take this drug?

    • If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
    • If you have any of these health problems: Kidney disease or liver disease.
    • If you are taking thioridazine.
    • If you are taking any of these drugs: Ciprofloxacin or fluvoxamine.
    • If you are taking any of these drugs: Linezolid or methylene blue.
    • If you have taken certain drugs for depression or Parkinson's disease in the last 14 days. This includes isocarboxazid, phenelzine, tranylcypromine, selegiline, or rasagiline. Very high blood pressure may happen. This is not a list of all drugs or health problems that interact with this drug. Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

    What are some things I need to know or do while I take this drug?

    • Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
    • Avoid driving and doing other tasks or actions that call for you to be alert until you see how this drug affects you.
    • To lower the chance of feeling dizzy or passing out, rise slowly if you have been sitting or lying down. Be careful going up and down stairs.
    • Low blood pressure, falls, and passing out have happened with this drug. Falls may lead to problems like broken bones and the need to go to the hospital. The chance of falling is raised with older people. Talk with the doctor.
    • If you have high blood sugar (diabetes), you will need to watch your blood sugar closely.
    • High blood pressure has happened with this drug. Have your blood pressure checked as you have been told by your doctor.
    • Talk with your doctor before you use alcohol, marijuana or other forms of cannabis, or prescription or OTC drugs that may slow your actions.
    • This drug may raise the chance of bleeding. Sometimes, bleeding can be life- threatening. Talk with the doctor.
    • A severe and sometimes deadly problem called serotonin syndrome may happen. The risk may be greater if you also take certain other drugs. Call your doctor right away if you have agitation; change in balance; confusion; hallucinations; fever; fast or abnormal heartbeat; flushing; muscle twitching or stiffness; seizures; shivering or shaking; sweating a lot; severe diarrhea, upset stomach, or throwing up; or very bad headache.
    • Some people may have a higher chance of eye problems with this drug. Your doctor may want you to have an eye exam to see if you have a higher chance of these eye problems. Call your doctor right away if you have eye pain, change in eyesight, or swelling or redness in or around the eye.
    • This drug can cause low sodium levels. Very low sodium levels can be life-threatening, leading to seizures, passing out, trouble breathing, or death.
    • This drug may affect certain lab tests. Tell all of your health care providers and lab workers that you take this drug.
    • If you are 65 or older , use this drug with care. You could have more side effects.
    • This drug may affect growth in children and teens in some cases. They may need regular growth checks. Talk with the doctor.
    • Tell your doctor if you are pregnant, may be pregnant, or plan to get pregnant while taking this drug. You will need to talk about the benefits and risks to you and the baby. Taking this drug in the third trimester of pregnancy may raise your risk of bleeding after delivery and may lead to some health problems in the newborn.
    • Tell your doctor if you are breast-feeding or plan to breast-feed. This drug passes into breast milk and may harm your baby.

    What are some side effects that I need to call my doctor about right away?
    WARNING/CAUTION:     Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

    • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
    • Signs of low sodium levels like headache, trouble focusing, memory problems, feeling confused, weakness, seizures, or change in balance.
    • Signs of bleeding like throwing up or coughing up blood; vomit that looks like coffee grounds; blood in the urine; black, red, or tarry stools; bleeding from the gums; abnormal vaginal bleeding; bruises without a cause or that get bigger; or bleeding you cannot stop.
    • Signs of high or low blood pressure like very bad headache or dizziness, passing out, or change in eyesight.
    • Seizures.
    • Trouble passing urine.
    • Sex problems have happened with drugs like this one. This includes lowered interest in sex, trouble having an orgasm, ejaculation problems, or trouble getting or keeping an erection. If you have any questions, talk with your doctor.
    • Liver problems have happened with this drug. Rarely, this has been deadly. Call your doctor right away if you have signs of liver problems like dark urine, tiredness, decreased appetite, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.
    • A severe skin reaction (Stevens-Johnson syndrome/toxic epidermal necrolysis) may happen. It can cause severe health problems that may not go away, and sometimes death. Get medical help right away if you have signs like red, swollen, blistered, or peeling skin (with or without fever); red or irritated eyes; or sores in your mouth, throat, nose, or eyes.

    What are some other side effects of this drug?

      All drugs may cause side effects. However , many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:
    • Constipation, diarrhea, stomach pain, upset stomach, throwing up, or decreased appetite.
    • Headache.
    • Dry mouth.
    • Trouble sleeping.
    • Feeling dizzy, sleepy, tired, or weak.
    • Sweating a lot.
    • Weight loss.
    • Nose or throat irritation.

    These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects. You may report side effects to your national health agency.


    How is this drug best taken?

    Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.

    All products:

    • Keep taking this drug as you have been told by your doctor or other health care provider , even if you feel well.
    • Take with or without food.
    • Do not stop taking this drug all of a sudden without calling your doctor. You may have a greater risk of side effects. If you need to stop this drug, you will want to slowly stop it as ordered by your doctor.

    Capsules:

    • Swallow whole. Do not chew, open, or crush.

    Sprinkle capsules:

    • Swallow whole. Do not chew or crush.
    • If you cannot swallow this drug whole, you may sprinkle the contents on applesauce. If you do this, swallow the mixture right away without chewing.
    • Those who have feeding tubes may use this drug. Use as you have been told. Flush the feeding tube after this drug is given.

    What do I do if I miss a dose?

    • Take a missed dose as soon as you think about it.
    • If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
    • Do not take 2 doses at the same time or extra doses.

    How do I store and/or throw out this drug?

    • Store at room temperature in a dry place. Do not store in a bathroom.
    • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
    • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

    General drug facts

    • If your symptoms or health problems do not get better or if they become worse, call your doctor.
    • Do not share your drugs with others and do not take anyone else's drugs.
    • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor , nurse, pharmacist, or other health care provider.
    • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.
     

    Warning

      For all patients taking this drug:

      • Drugs like this one have raised the chance of suicidal thoughts or actions in children and young adults. The risk may be greater in people who have had these thoughts or actions in the past. All people who take this drug need to be watched closely. Call the doctor right away if signs like depression, nervousness, restlessness, grouchiness, panic attacks, or changes in mood or actions are new or worse. Call the doctor right away if any thoughts or actions of suicide occur.

      Children:

      • This drug is not approved for use in all children. Talk with the doctor to be sure that this drug is right for your child.

    What is this drug used for?

    • It is used to treat depression.
    • It is used to treat anxiety.
    • It may be given to you for other reasons. Talk with the doctor.

    What do I need to tell my doctor BEFORE I take this drug?

    • If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
    • If you are taking any of these drugs: Linezolid or methylene blue.
    • If you are taking any of these drugs: Citalopram or pimozide.
    • If you have taken certain drugs for depression or Parkinson's disease in the last 14 days. This includes isocarboxazid, phenelzine, tranylcypromine, selegiline, or rasagiline. Very high blood pressure may happen. This is not a list of all drugs or health problems that interact with this drug. Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

    What are some things I need to know or do while I take this drug?

    • Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
    • Avoid driving and doing other tasks or actions that call for you to be alert until you see how this drug affects you.
    • Do not stop taking this drug all of a sudden without calling your doctor. You may have a greater risk of side effects. If you need to stop this drug, you will want to slowly stop it as ordered by your doctor.
    • Avoid drinking alcohol while taking this drug.
    • Talk with your doctor before you use marijuana, other forms of cannabis, or prescription or OTC drugs that may slow your actions.
    • In depression, sleep and appetite may get better soon after starting this drug. Other depression signs may take up to 4 weeks to get better.
    • This drug may raise the chance of bleeding. Sometimes, bleeding can be life- threatening. Talk with the doctor.
    • This drug can cause low sodium levels. Very low sodium levels can be life-threatening, leading to seizures, passing out, trouble breathing, or death.
    • If you are 65 or older, use this drug with care. You could have more side effects.
    • This drug may affect growth in children and teens in some cases. They may need regular growth checks. Talk with the doctor.
    • Tell your doctor if you are pregnant, may be pregnant, or plan to get pregnant while taking this drug. You will need to talk about the benefits and risks to you and the baby. Taking this drug in the third trimester of pregnancy may raise your risk of bleeding after delivery and may lead to some health problems in the newborn.
    • Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.

    What are some side effects that I need to call my doctor about right away?
    WARNING/CAUTION:     Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

    • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
    • Signs of low sodium levels like headache, trouble focusing, memory problems, feeling confused, weakness, seizures, or change in balance.
    • Signs of bleeding like throwing up or coughing up blood; vomit that looks like coffee grounds; blood in the urine; black, red, or tarry stools; bleeding from the gums; abnormal vaginal bleeding: bruises without a cause or that get bigger; or bleeding you cannot stop.
    • Seizures.
    • Fever or chills.
    • Painful erection (hard penis) or an erection that lasts for longer than 4 hours.
    • Sex problems have happened with drugs like this one. This includes lowered interest in sex, trouble having an orgasm, ejaculation problems, or trouble getting or keeping an erection. If you have any questions, talk with your doctor.
    • Some people may have a higher chance of eye problems with this drug. Your doctor may want you to have an eye exam to see if you have a higher chance of these eye problems. Call your doctor right away if you have eye pain, change in eyesight, or swelling or redness in or around the eye.
    • A severe and sometimes deadly problem called serotonin syndrome may happen. The risk may be greater if you also take certain other drugs. Call your doctor right away if you have agitation; change in balance; confusion; hallucinations; fever; fast or abnormal heartbeat; flushing; muscle twitching or stiffness; seizures; shivering or shaking; sweating a lot; severe diarrhea, upset stomach, or throwing up; or very bad headache.

    What are some other side effects of this drug?

      All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:
    • Feeling dizzy, sleepy, tired, or weak.
    • Upset stomach.
    • Diarrhea or constipation.
    • Dry mouth.
    • Trouble sleeping.
    • Sweating a lot.
    • Flu-like signs.
    • Runny nose.
    • Headache.
    • Yawning.

    These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects. You may report side effects to your national health agency.


    How is this drug best taken?

    Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.

    All products:

    • Take with or without food.
    • Keep taking this drug as you have been told by your doctor or other health care provider, even if you feel well.

    Oral solution:

    • Measure liquid doses carefully. Use the measuring device that comes with this drug. If there is none, ask the pharmacist for a device to measure this drug.

    What do I do if I miss a dose?

    • Take a missed dose as soon as you think about it.
    • If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
    • Do not take 2 doses at the same time or extra doses.

    How do I store and/or throw out this drug?

    • Store at room temperature in a dry place. Do not store in a bathroom.
    • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
    • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

    General drug facts

    • If your symptoms or health problems do not get better or if they become worse, call your doctor.
    • Do not share your drugs with others and do not take anyone else's drugs.
    • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
    • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.
     

    Warning

    • Drugs like this one have raised the chance of suicidal thoughts or actions in children and young adults. The risk may be greater in people who have had these thoughts or actions in the past. All people who take this drug need to be watched closely. Call the doctor right away if signs like depression, nervousness, restlessness, grouchiness, panic attacks, or changes in mood or actions are new or worse. Call the doctor right away if any thoughts or actions of suicide occur.
    • This drug is not approved for use in all children. Talk with the doctor to be sure that this drug is right for your child.

    What is this drug used for?

    • It is used to treat depression.
    • It is used to treat obsessive-compulsive problems.
    • It is used to treat mood problems caused by monthly periods.
    • It is used to treat eating problems.
    • It is used to treat panic attacks.
    • It may be given to you for other reasons. Talk with the doctor.

    What do I need to tell my doctor BEFORE I take this drug?

    • If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
    • If you are taking any of these drugs: Linezolid, methylene blue, pimozide, or thioridazine.
    • If you have taken certain drugs for depression or Parkinson's disease in the last 14 days. This includes isocarboxazid, phenelzine, tranylcypromine, selegiline, or rasagiline. Very high blood pressure may happen.
    • If you are taking any drugs that can cause a certain type of heartbeat that is not normal (prolonged QT interval). There are many drugs that can do this. Ask your doctor or pharmacist if you are not sure. This is not a list of all drugs or health problems that interact with this drug.

    Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.


    What are some things I need to know or do while I take this drug?

    • Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
    • Avoid driving and doing other tasks or actions that call for you to be alert until you see how this drug affects you.
    • Do not stop taking this drug all of a sudden without calling your doctor. You may have a greater risk of side effects. If you need to stop this drug, you will want to slowly stop it as ordered by your doctor.
    • Avoid drinking alcohol while taking this drug.
    • Talk with your doctor before you use marijuana, other forms of cannabis, or prescription or OTC drugs that may slow your actions.
    • If you have high blood sugar (diabetes), you will need to watch your blood sugar closely.
    • It may take several weeks to see the full effects.
    • This drug may raise the chance of bleeding. Sometimes, bleeding can be life- threatening. Talk with the doctor.
    • Severe and sometimes deadly reactions along with a rash have rarely happened with this drug. Lung, kidney, or liver problems have also happened. Call your doctor right away if you have a change in the amount of urine passed, dark urine, decreased appetite, upset stomach or stomach pain, light-colored stools, throwing up, yellow skin or eyes, or shortness of breath.
    • Some people may have a higher chance of eye problems with this drug. Your doctor may want you to have an eye exam to see if you have a higher chance of these eye problems. Call your doctor right away if you have eye pain, change in eyesight, or swelling or redness in or around the eye.
    • This drug can cause low sodium levels. Very low sodium levels can be life-threatening, leading to seizures, passing out, trouble breathing, or death.
    • This drug may affect growth in children and teens in some cases. They may need regular growth checks. Talk with the doctor.
    • If you are 65 or older , use this drug with care. You could have more side effects.
    • Tell your doctor if you are pregnant, may be pregnant, or plan to get pregnant while taking this drug. You will need to talk about the benefits and risks to you and the baby. Taking this drug in the third trimester of pregnancy may raise your risk of bleeding after delivery and may lead to some health problems in the newborn.
    • Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.

    What are some side effects that I need to call my doctor about right away?
    WARNING/CAUTION:     Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

    • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
    • Signs of low sodium levels like headache, trouble focusing, memory problems, feeling confused, weakness, seizures, or change in balance.
    • A big weight gain or loss.
    • Seizures.
    • Dizziness.
    • Slow heartbeat.
    • Any unexplained bruising or bleeding.
    • Anxiety.
    • Unusual thirst.
    • Period (menstrual) changes.
    • Passing urine more often.
    • Trouble controlling body movements.
    • Joint pain.
    • Swollen gland.
    • Painful erection (hard penis) or an erection that lasts for longer than 4 hours.
    • Sex problems have happened with drugs like this one. This includes lowered interest in sex, trouble having an orgasm, ejaculation problems, or trouble getting or keeping an erection. If you have any questions, talk with your doctor.
    • A severe and sometimes deadly problem called serotonin syndrome may happen. The risk may be greater if you also take certain other drugs. Call your doctor right away if you have agitation; change in balance; confusion; hallucinations; fever; fast or abnormal heartbeat; flushing; muscle twitching or stiffness; seizures; shivering or shaking; sweating a lot; severe diarrhea, upset stomach, or throwing up; or very bad headache.
    • A type of abnormal heartbeat (prolonged QT interval) has happened with this drug. Sometimes, this has led to another type of unsafe abnormal heartbeat (torsades de pointes). Call your doctor right away if you have a fast or abnormal heartbeat, or if you pass out.

    What are some other side effects of this drug?

      All drugs may cause side effects. However , many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:
    • Constipation, diarrhea, upset stomach, throwing up, or decreased appetite.
    • Dry mouth.
    • Feeling sleepy.
    • Strange or odd dreams.
    • Trouble sleeping.
    • Feeling tired or weak.
    • Flu-like signs.
    • Yawning.
    • Hot flashes.
    • Feeling nervous and excitable.
    • Shakiness.
    • Sweating a lot.
    • Headache.
    • Nose or throat irritation.

    These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects. You may report side effects to your national health agency.


    How is this drug best taken?

    Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.

    All products:

    • Take with or without food.
    • Keep taking this drug as you have been told by your doctor or other health care provider , even if you feel well.

    Long-acting products:

    • Swallow whole. Do not chew, break, or crush.

    Liquid (solution):

    • Measure liquid doses carefully. Use the measuring device that comes with this drug. If there is none, ask the pharmacist for a device to measure this drug.

    What do I do if I miss a dose?

    • Take a missed dose as soon as you think about it.
    • If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
    • Do not take 2 doses at the same time or extra doses. How do I store and/or throw out this drug?
    • Store at room temperature protected from light. Store in a dry place. Do not store in a bathroom. f
    • Keep lid tightly closed.
    • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
    • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

    General drug facts

    • If your symptoms or health problems do not get better or if they become worse, call your doctor.
    • Do not share your drugs with others and do not take anyone else's drugs.
    • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor , nurse, pharmacist, or other health care provider.
    • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.
     

    Warning

    • Drugs like this one have raised the chance of suicidal thoughts or actions in children and young adults. The risk may be greater in people who have had these thoughts or actions in the past. All people who take this drug need to be watched closely. Call the doctor right away if signs like depression, nervousness, restlessness, grouchiness, panic attacks, or changes in mood or actions are new or worse. Call the doctor right away if any thoughts or actions of suicide occur.
    • This drug is not approved for use in children. Talk with the doctor.

    What is this drug used for?

    • It is used to treat depression.
    • It is used to treat obsessive-compulsive problems.
    • It is used to treat panic attacks.
    • It is used to treat anxiety.
    • It is used to treat post-traumatic stress.
    • It is used to treat mood problems caused by monthly periods.
    • It is used to treat hot flashes caused by menopause.
    • It may be given to you for other reasons. Talk with the doctor.

    What do I need to tell my doctor BEFORE I take this drug?

    For all uses of this drug:

    • If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
    • If you have narrow-angle glaucoma.
    • If you are taking any of these drugs: Linezolid, methylene blue, pimozide, or thioridazine.
    • If you have taken certain drugs for depression or Parkinson's disease in the last 14 days. This includes isocarboxazid, phenelzine, tranylcypromine, selegiline, or rasagiline. Very high blood pressure may happen.

    For treating hot flashes caused by menopause:

    • If you are pregnant or may be pregnant. Do not take this drug if you are pregnant. This is not a list of all drugs or health problems that interact with this drug.

    Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.


    What are some things I need to know or do while I take this drug?

    • Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
    • Avoid driving and doing other tasks or actions that call for you to be alert until you see how this drug affects you.
    • Do not stop taking this drug all of a sudden without calling your doctor. You may have a greater risk of side effects. If you need to stop this drug, you will want to slowly stop it as ordered by your doctor.
    • Avoid drinking alcohol while taking this drug.
    • Talk with your doctor before you use marijuana, other forms of cannabis, or prescription or OTC drugs that may slow your actions.
    • It may take several weeks to see the full effects.
    • This drug may raise the chance of a broken bone. Talk with the doctor.
    • This drug may raise the chance of bleeding. Sometimes, bleeding can be life- threatening. Talk with the doctor.
    • Some people may have a higher chance of eye problems with this drug. Your doctor may want you to have an eye exam to see if you have a higher chance of these eye problems. Call your doctor right away if you have eye pain, change in eyesight, or swelling or redness in or around the eye.
    • This drug can cause low sodium levels. Very low sodium levels can be life-threatening, leading to seizures, passing out, trouble breathing, or death.
    • If you are 65 or older , use this drug with care. You could have more side effects.
    • This drug may affect growth in children and teens in some cases. They may need regular growth checks. Talk with the doctor.
    • This drug may affect being able to father a child. It is not known if this effect will go back to normal.
    • Tell your doctor if you are pregnant, may be pregnant, or plan to get pregnant while taking this drug. You will need to talk about the benefits and risks to you and the baby. Taking this drug in the first trimester of pregnancy may raise the risk of birth defects (mainly heart defects) in the unborn baby. Taking this drug in the third trimester of pregnancy may raise your risk of bleeding after delivery and may lead to some health problems in the newborn.
    • Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.

    What are some side effects that I need to call my doctor about right away?
    WARNING/CAUTION:     Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

    • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
    • Signs of low sodium levels like headache, trouble focusing, memory problems, feeling confused, weakness, seizures, or change in balance.
    • Signs of infection like fever , chills, very bad sore throat, ear or sinus pain, cough, more sputum or change in color of sputum, pain with passing urine, mouth sores, or wound that will not heal.
    • Signs of bleeding like throwing up or coughing up blood; vomit that looks like coffee grounds; blood in the urine; black, red, or tarry stools; bleeding from the gums; abnormal vaginal bleeding; bruises without a cause or that get bigger; or bleeding you cannot stop.
    • Severe dizziness or passing out.
    • Bone pain.
    • Seizures.
    • A big weight loss.
    • A burning, numbness, or tingling feeling that is not normal.
    • Painful erection (hard penis) or an erection that lasts for longer than 4 hours.
    • Sex problems have happened with drugs like this one. This includes lowered interest in sex, trouble having an orgasm, ejaculation problems, or trouble getting or keeping an erection. If you have any questions, talk with your doctor.
    • A severe and sometimes deadly problem called serotonin syndrome may happen. The risk may be greater if you also take certain other drugs. Call your doctor right away if you have agitation; change in balance; confusion; hallucinations; fever; fast or abnormal heartbeat; flushing; muscle twitching or stiffness; seizures; shivering or shaking; sweating a lot; severe diarrhea, upset stomach, or throwing up; or very bad headache.

    What are some other side effects of this drug?

      All drugs may cause side effects. However , many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:
    • Feeling dizzy, sleepy, tired, or weak.
    • Feeling nervous and excitable.
    • Headache.
    • Constipation, diarrhea, stomach pain, upset stomach, throwing up, or decreased appetite.
    • Gas.
    • Dry mouth.
    • Trouble sleeping.
    • Shakiness.
    • Yawning.
    • Back pain.
    • Sweating.

    These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects. You may report side effects to your national health agency.


    How is this drug best taken?

    Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.

    All products:

    • Take with or without food.
    • Keep taking this drug as you have been told by your doctor or other health care provider , even if you feel well.

    Liquid (suspension):

    • Shake well before use.
    • Measure liquid doses carefully. Use the measuring device that comes with this drug. If there is none, ask the pharmacist for a device to measure this drug.
    • Take this drug in the morning unless your doctor tells you otherwise.

    Tablets:

    • Some brands of this drug may need to be swallowed whole. Check with your doctor or pharmacist if you have questions about whether your brand must be swallowed whole.
    • Take this drug in the morning unless your doctor tells you otherwise. Controlled-release tablets:
    • Swallow whole. Do not chew, break, or crush.
    • Take this drug in the morning unless your doctor tells you otherwise.

    Capsules:

    • Take this drug at bedtime.

    What do I do if I miss a dose?

    • Take a missed dose as soon as you think about it.
    • If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
    • Do not take 2 doses at the same time or extra doses.

    How do I store and/or throw out this drug?

    All products:

    • Store at room temperature in a dry place. Do not store in a bathroom.
    • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
    • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

    Capsules:

    • Protect from light.

    General drug facts

    • If your symptoms or health problems do not get better or if they become worse, call your doctor.
    • Do not share your drugs with others and do not take anyone else's drugs.
    • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor , nurse, pharmacist, or other health care provider.
    • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.
     

    What is this drug used for?

    • It is used to treat high blood pressure.
    • It is used to treat chest pain or pressure.
    • It is used to help certain heart problems.
    • It is used to prevent migraine headaches.
    • It is used to treat tremor (essential).
    • It is used after a heart attack to help prevent future heart attacks and lengthen life.
    • It is used to treat pheochromocytoma.
    • It is used to treat certain types of abnormal heartbeats.
    • It may be given to you for other reasons. Talk with the doctor.

    What do I need to tell my doctor BEFORE I take this drug?

    • If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
    • If you have any of these health problems: Certain types of abnormal heartbeats called heart block or sick-sinus syndrome, heart failure (weak heart), low blood pressure, poor blood flow to the arms or legs, shock caused by heart problems, or a slow heartbeat.
    • If you have any of these health problems: Asthma or other breathing problems like COPD (chronic obstructive pulmonary disease).

    This is not a list of all drugs or health problems that interact with this drug.

    Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.


    What are some things I need to know or do while I take this drug?

    All products:

    • Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
    • Avoid driving and doing other tasks or actions that call for you to be alert until you see how this drug affects you.
    • To lower the chance of feeling dizzy or passing out, rise slowly if you have been sitting or lying down. Be careful going up and down stairs.
    • Check blood pressure and heart rate as the doctor has told you.
    • This drug may affect certain lab tests. Tell all of your health care providers and lab workers that you take this drug.
    • Talk with your doctor before you drink alcohol.
    • If you smoke, talk with your doctor.
    • This drug may prevent some signs of low blood sugar like fast heartbeat. This may raise the risk of severe or long-lasting low blood sugar , especially in people with diabetes, children, and people who are fasting. This includes people who are having surgery, are not eating like normal, or are throwing up. If you have questions, talk with the docto.
    • If you have high blood sugar (diabetes), you will need to watch your blood sugar closely.
    • Do not stop taking this drug all of a sudden. If you do, chest pain that is worse and in some cases heart attack may occur. The risk may be greater if you have certain types of heart disease. To avoid side effects, you will want to slowly stop this drug as ordered by your doctor. Call your doctor right away if you have new or worse chest pain or if other heart problems occur.
    • This drug may make it harder to tell if you have signs of an overactive thyroid like fast heartbeat. If you have an overactive thyroid and stop taking this drug all of a sudden, it may get worse and could be life-threatening. Talk with your doctor.
    • If you are taking this drug and have high blood pressure, talk with your doctor before using OTC products that may raise blood pressure. These include cough or cold drugs, diet pills, stimulants, non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, and some natural products or aids.
    • If you have had a very bad allergic reaction, talk with your doctor. You may have a chance of an even worse reaction if you come into contact with what caused your allergy. If you use epinephrine to treat very bad allergic reactions, talk with your doctor. Epinephrine may not work as well while you are taking this drug.
    • Tell your doctor if you are pregnant, plan on getting pregnant, or are breast-feeding. You will need to talk about the benefits and risks to you and the baby.

    Oral solution:

    • Make sure you have the right liquid; there is more than one strength.

    What are some side effects that I need to call my doctor about right away?
    WARNING/CAUTION:     Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

    • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
    • Signs of low blood sugar like dizziness, headache, feeling sleepy, feeling weak, shaking, a fast heartbeat, confusion, hunger , or sweating.
    • Signs of lupus like a rash on the cheeks or other body parts, sunburn easy, muscle or joint pain, chest pain or shortness of breath, or swelling in the arms or legs.
    • Very bad dizziness or passing out.
    • Chest pain that is new or worse.
    • Slow heartbeat.
    • A heartbeat that does not feel normal.
    • Shortness of breath, a big weight gain, or swelling in the arms or legs.
    • Feeling confused.
    • Hallucinations (seeing or hearing things that are not there).
    • Memory problems or loss.
    • Depression or other mood changes.
    • A burning, numbness, or tingling feeling that is not normal.
    • Feeling cold in the arms or legs.
    • Change in color of hands, feet, or other areas. Skin may turn pale, blue, gray, purple, or red.
    • Change in eyesight.
    • Any unexplained bruising or bleeding.
    • Fever , chills, or sore throat.
    • Not able to get or keep an erection.
    • Severe skin reactions have happened with this drug. These have included Stevens- Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and other severe skin reactions. Get medical help right away if you have signs like red, swollen, blistered, or peeling skin; other skin irritation (with or without fever); red or irritated eyes; or sores in your mouth, throat, nose, or eyes.

    What are some other side effects of this drug?

      All drugs may cause side effects. However , many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:
    • Feeling dizzy, sleepy, tired, or weak.
    • Upset stomach or throwing up.
    • Stomach pain or cramps.
    • Diarrhea or constipation.
    • Trouble sleeping.
    • Strange or odd dreams.

    These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects. You may report side effects to your national health agency.


    How is this drug best taken?

    Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.

    Inderal XL and InnoPran XL:

    • Take with or without food but take the same way each time. Always take with food or always take on an empty stomach.
    • Take at bedtime if taking once a day.
    • Keep taking this drug as you have been told by your doctor or other health care provider , even if you feel well.

    All other oral products:

    • Some drugs may need to be taken with food or on an empty stomach. For some drugs it does not matter. Check with your pharmacist about how to take this drug.
    • Keep taking this drug as you have been told by your doctor or other health care provider , even if you feel well.

    Oral solution:

    • Measure liquid doses carefully. Use the measuring device that comes with this drug. If there is none, ask the pharmacist for a device to measure this drug.

    All long-acting products:

    • Swallow capsule whole. Do not chew, break, or crush. Injection:
    • It is given as a shot into a vein.

    What do I do if I miss a dose?

    All oral products:

    • Take a missed dose as soon as you think about it.
    • If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
    • Do not take 2 doses at the same time or extra doses.

    Injection:

    • Call your doctor to find out what to do.

    How do I store and/or throw out this drug?

    All oral products:

    • Store at room temperature. Do not freeze.
    • Protect from heat, cold, and light.
    • Keep lid tightly closed.
    • Store in a dry place. Do not store in a bathroom.

    Injection:

    • If you need to store this drug at home, talk with your doctor , nurse, or pharmacist about how to store it.

    All products:

    • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
    • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

    General drug facts

    • If your symptoms or health problems do not get better or if they become worse, call your doctor.
    • Do not share your drugs with others and do not take anyone else's drugs.
    • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor , nurse, pharmacist, or other health care provide.
    • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.
     

    Warning

    • Drugs like this one have raised the chance of suicidal thoughts or actions in children and young adults. The risk may be greater in people who have had these thoughts or actions in the past. All people who take this drug need to be watched closely. Call the doctor right away if signs like depression, nervousness, restlessness, grouchiness, panic attacks, or changes in mood or actions are new or worse. Call the doctor right away if any thoughts or actions of suicide occur.

    What is this drug used for?

    • It is used to treat depression.
    • It is used to treat obsessive-compulsive problems.
    • It is used to treat panic attacks.
    • It is used to treat post-traumatic stress.
    • It is used to treat mood problems caused by monthly periods.
    • It is used to treat social anxiety problems.
    • It may be given to you for other reasons. Talk with the doctor.

    What do I need to tell my doctor BEFORE I take this drug?

    All products:

    • If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
    • If you have liver disease.
    • If you are taking any of these drugs: Linezolid or methylene blue.
    • If you are taking pimozide.
    • If you have taken certain drugs for depres sion or Parkinson's disease in the last 14 days. This includes isocarboxazid, phenelzine, tranylcypromine, selegiline, or rasagiline. Very high blood pressure may happen.
    • If you are taking any drugs that can cause a certain type of heartbeat that is not normal (prolonged QT interval). There are many drugs that can do this. Ask your doctor or pharmacist if you are not sure.

    Oral solution:

    • If you have a latex allergy. The dropper has rubber.
    • If you are taking disulfiram.
    • If you are pregnant or may be pregnant. This form of this drug has alcohol in it. Do not take this form of this drug if you are pregnant. This is not a list of all drugs or health problems that interact with this drug. Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take- this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

    What are some things I need to know or do while I take this drug?

    • Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
    • Avoid driving and doing other tasks or actions that call for you to be alert until you see how this drug affects you.
    • Do not stop taking this drug all of a sudden without calling your doctor. You may have a greater risk of side effects. If you need to stop this drug, you will want to slowly stop it as ordered by your doctor.
    • Avoid drinking alcohol while taking this drug.
    • Talk with your doctor before you use marijuana, other forms of cannabis, or prescription or OTC drugs that may slow your actions.
    • In depression, sleep and appetite may get better soon after starting this drug. Other depression signs may take up to 4 weeks to get better.
    • If you are allergic to tartrazine (FD&C Yellow No. 5), talk with your doctor. Some products have tartrazine.
    • This drug may raise the chance of a broken bone. Talk with the doctor.
    • This drug may raise the chance of bleeding. Sometimes, bleeding can be life- threatening. Talk with the doctor.
    • This drug can cause low sodium levels. Very low sodium levels can be life-threatening, leading to seizures, passing out, trouble breathing, or death.
    • Some people may have a higher chance of eye problems with this drug. Your doctor may want you to have an eye exam to see if you have a higher chance of these eye problems. Call your doctor right away if you have eye pain, change in eyesight, or swelling or redness in or around the eye.
    • A severe and sometimes deadly problem called serotonin syndrome may happen. The risk may be greater if you also take certain other drugs. Call your doctor right away if you have agitation; change in balance; confusion; hallucinations; fever; fast or abnormal heartbeat; flushing; muscle twitching or stiffness; seizures; shivering or shaking; sweating a lot; severe diarrhea, upset stomach, or throwing up; or very bad headache.
    • This drug may affect certain lab tests. Tell all of your health care providers and lab workers that you take this drug.
    • If you are 65 or older , use this drug with care. You could have more side effects.
    • This drug is not approved for use in all children. Talk with the doctor to be sure that this drug is right for your child.
    • If the patient is a child, use this drug with care. The risk of some side effects may be higher in children.
    • This drug may affect growth in children and teens in some cases. They may need regular growth checks. Talk with the doctor.
    • Tell your doctor if you are pregnant, may be pregnant, or plan to get pregnant while taking this drug. You will need to talk about the benefits and risks to you and the baby. Taking this drug in the third trimester of pregnancy may raise your risk of bleeding after delivery and may lead to some health problems in the newborn.
    • Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.

    What are some side effects that I need to call my doctor about right away?
    WARNING/CAUTION:     Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

    • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
    • Signs of low sodium levels like headache, trouble focusing, memory problems, feeling confused, weakness, seizures, or change in balance.
    • Signs of bleeding like throwing up or coughing up blood; vomit that looks like coffee grounds; blood in the urine; black, red, or tarry stools; bleeding from the gums; abnormal vaginal bleeding; bruises without a cause or that get bigger; or bleeding you cannot stop.
    • Signs of a very bad skin reaction (Stevens-Johnson syndrome/toxic epidermal necrolysis) like red, swollen, blistered, or peeling skin (with or without fever); red or irritated eyes; or sores in the mouth, throat, nose, or eyes.
    • Seizures.
    • Not able to control bladder.
    • A big weight gain or loss.
    • Sex problems have happened with drugs like this one. This includes lowered interest in sex, trouble having an orgasm, ejaculation problems, or trouble getting or keeping an erection. If you have any questions, talk with your doctor.
    • Liver problems have rarely happened with this drug. Sometimes, this has been deadly. Call your doctor right away if you have signs of liver problems like dark urine, tiredness, decreased appetite, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.
    • A type of abnormal heartbeat (prolonged QT interval) has happened with this drug. Sometimes, this has led to another type of unsafe abnormal heartbeat (torsades de pointes). Call your doctor right away if you have a fast or abnormal heartbeat, or if you pass out.

    What are some other side effects of this drug?

      All drugs may cause side effects. However , many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:
    • Feeling dizzy, sleepy, tired, or weak.
    • Constipation, diarrhea, stomach pain, upset stomach, throwing up, or decreased appetite.
    • Dry mouth.
    • Trouble sleeping.
    • Sweating a lot.
    • Shakiness.

    These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects. You may report side effects to your national health agency.


    How is this drug best taken?

    Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.

    Tablets:

    • Take with or without food.
    • Keep taking this drug as you have been told by your doctor or other health care provider , even if you feel well.

    Capsules:

    • Take with or without food as you have been told by your doctor.
    • Swallow whole. Do not chew, open, or crush.
    • Keep taking this drug as you have been told by your doctor or other health care provider , even if you feel well.

    Oral solution:

    • Only use the measuring device that comes with this drug.
    • Mix liquid with 1/ cup of water , ginger ale, lemon-lime soda, lemonade, or orange 2 juice.
    • After mixing, take your dose right away. Do not store for future use.
    • This drug may look hazy after mixing. This is normal.
    • Keep taking this drug as you have been told by your doctor or other health care provider , even if you feel well.

    What do I do if I miss a dose?

    • Take a missed dose as soon as you think about it.
    • If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
    • Do not take 2 doses at the same time or extra doses.

    How do I store and/or throw out this drug?

    • Store at room temperature in a dry place. Do not store in a bathroom.
    • Keep lid tightly closed.
    • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
    • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

    General drug facts

    • If your symptoms or health problems do not get better or if they become worse, call your doctor.
    • Do not share your drugs with others and do not take anyone else's drugs.
    • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor , nurse, pharmacist, or other health care provider.
    • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.
     

    Warning

    • Drugs like this one have raised the chance of suicidal thoughts or actions in children and young adults. The risk may be greater in people who have had these thoughts or actions in the past. All people who take this drug need to be watched closely. Call the doctor right away if signs like depression, nervousness, restlessness, grouchiness, panic attacks, or changes in mood or actions are new or worse. Call the doctor right away if any thoughts or actions of suicide occur.
    • This drug is not approved for use in children. Talk with the doctor.

    What is this drug used for?

    • It is used to treat depression.
    • It is used to treat anxiety.
    • It is used to treat panic attacks.
    • It may be given to you for other reasons. Talk with the doctor.

    What do I need to tell my doctor BEFORE I take this drug?

    • If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
    • If you have high blood pressure.
    • If you have narrow-angle glaucoma.
    • If you are taking a weight loss drug.
    • If you are taking any of these drugs: Linezolid or methylene blue.
    • If you have taken certain drugs for depression or Parkinson's disease in the last 14 days. This includes isocarboxazid, phenelzine, tranylcypromine, selegiline, or rasagiline. Very high blood pressure may happen.

    This is not a list of all drugs or health problems that interact with this drug.

    Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.


    What are some things I need to know or do while I take this drug?

    All products:

    • Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
    • Avoid driving and doing other tasks or actions that call for you to be alert until you see how this drug affects you.
    • Do not stop taking this drug all of a sudden without calling your doctor. You may have a greater risk of side effects. Sometimes, these can be severe and last for a long time. If you need to stop this drug, slowly stop it as ordered by your doctor. Talk with your doctor if you have any new or worsening signs.
    • High blood pressure has happened with this drug. Have your blood pressure checked as you have been told by your doctor.
    • Avoid drinking alcohol while taking this drug.
    • Talk with your doctor before you use marijuana, other forms of cannabis, or prescription or OTC drugs that may slow your actions.
    • This drug may raise the chance of bleeding. Sometimes, bleeding can be life- threatening. Talk with the doctor.
    • If you have bipolar disorder , manic episodes may happen while taking this drug. Call your doctor if you have signs of a manic episode.
    • Some people may have a higher chance of eye problems with this drug. Your doctor may want you to have an eye exam to see if you have a higher chance of these eye problems. Call your doctor right away if you have eye pain, change in eyesight, or swelling or redness in or around the eye.
    • Low blood sodium levels may happen with this drug. In very bad cases, this can be deadly. Talk with the doctor.
    • High cholesterol has happened with this drug. If you have questions, talk with the doctor.
    • This drug may affect certain lab tests. Tell all of your health care providers and lab workers that you take this drug.
    • If you are 65 or older , use this drug with care. You could have more side effects.
    • This drug may affect growth in children and teens in some cases. They may need regular growth checks. Talk with the doctor.
    • Tell your doctor if you are pregnant, may be pregnant, or plan to get pregnant while taking this drug. You will need to talk about the benefits and risks to you and the baby. Taking this drug in mid to late pregnancy may lead to some health problems in the mother (like bleeding after delivery) or the newborn.
    • Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.

    Extended-release capsules:

    • You may see parts of this drug in your stool. This is normal and not a cause for concern.

    Extended-release tablets:

    • You may see the tablet shell in your stool. This is normal and not a cause for concern.

    What are some side effects that I need to call my doctor about right away?
    WARNING/CAUTION:     Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

    • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
    • Signs of low sodium levels like headache, trouble focusing, memory problems, feeling confused, weakness, seizures, or change in balance.
    • Signs of bleeding like throwing up or coughing up blood; vomit that looks like coffee grounds; blood in the urine; black, red, or tarry stools; bleeding from the gums; abnormal vaginal bleeding; bruises without a cause or that get bigger; or bleeding you cannot stop.
    • Signs of high blood pressure like very bad headache or dizziness, passing out, or change in eyesight.
    • Seizures.
    • Chest pain or pressure.
    • Shortness of breath.
    • Cough.
    • Bone pain.
    • Sex problems have happened with drugs like this one. This includes lowered interest in sex, trouble having an orgasm, ejaculation problems, or trouble getting or keeping an erection. If you have any questions, talk with your doctor.
    • A severe and sometimes deadly problem called serotonin syndrome may happen. The risk may be greater if you also take certain other drugs. Call your doctor right away if you have agitation; change in balance; confusion; hallucinations; fever; fast or abnormal heartbeat; flushing; muscle twitching or stiffness; seizures; shivering or shaking; sweating a lot; severe diarrhea, upset stomach, or throwing up; or very bad headache.

    What are some other side effects of this drug?

      All drugs may cause side effects. However , many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:
    • Trouble sleeping.
    • Feeling nervous and excitable.
    • Anxiety.
    • Weight loss.
    • Feeling dizzy, sleepy, tired, or weak.
    • Shakiness.
    • Headache.
    • Sweating a lot.
    • Constipation, diarrhea, stomach pain, upset stomach, throwing up, or decreased appetite.
    • Gas.
    • Dry mouth.
    • Strange or odd dreams.
    • Yawning.

    These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects. You may report side effects to your national health agency.


    How is this drug best taken?

    Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.

    All products:

    • Take this drug with food.
    • Take this drug at the same time of day.
    • Keep taking this drug as you have been told by your doctor or other health care provider , even if you feel well.

    Extended-release capsules:

    • Swallow whole. Do not crush, chew, or dissolve the capsule or its contents.
    • You may sprinkle contents of capsule on applesauce. Do not chew. Swallow right away and follow with cool water.

    Extended-release tablets:

    • Swallow whole. Do not chew, break, or crush.
    • Take with a full glass of water.

    What do I do if I miss a dose?

    • Take a missed dose as soon as you think about it.
    • If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
    • Do not take 2 doses at the same time or extra doses.

    How do I store and/or throw out this drug?

    • Store at room temperature in a dry place. Do not store in a bathroom.
    • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
    • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

    General drug facts

    • If your symptoms or health problems do not get better or if they become worse, call your doctor.
    • Do not share your drugs with others and do not take anyone else's drugs.
    • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor , nurse, pharmacist, or other health care provider.
    • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.