Your healthcare professionals (e.g., doctor or pharmacist) may already be aware of any possible drug interactions and may be monitoring you for it. Do not start, stop or change the dosage of any medicine before checking with them first.
This drug should not be used with the following medications because very serious interactions may occur: MAO inhibitors.
Avoid taking MAO inhibitors (e.g., furazolidone, isocarboxazid, linezolid, moclobemide, phenelzine, procarbazine, selegiline, tranylcypromine) within 2 weeks before, during, and after treatment with this medication. In some cases, a serious, possibly fatal drug interaction may occur.
If you are currently using any of these medications listed above, tell your doctor or pharmacist before starting this medication.
Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: certain antidepressants (e.g., tricyclic antidepressants such as nortriptyline and imipramine, SSRIs such as fluoxetine and paroxetine, and SSNRIs such as venlafaxine), alpha blockers (e.g., prazosin), certain antihistamines (e.g., diphenhydramine), beta blockers (e.g., atenolol, metoprolol), drugs for high blood pressure (e.g., clonidine, guanabenz, methyldopa), certain drugs for mental/mood conditions (e.g., antipsychotics such as chlorpromazine/haloperidol, lithium), certain pain medicines (e.g., meperidine, propoxyphene), certain anti-seizure drugs (e.g., ethosuximide, phenytoin, phenobarbital), stimulants (e.g., norepinephrine, phenylephrine), veratrum alkaloids (e.g., cevadine, veratridine).
Certain foods and drugs can affect the amount of acid in your stomach/intestines or urine. This can affect how well your body absorbs and uses this medication. Tell your doctor if you take any of these products: ammonium chloride, antacids, anti-ulcer medicine (e.g., H2 blockers such as famotidine and ranitidine, proton pump inhibitors such as omeprazole and lansoprazole), ascorbic acid (vitamin C), aspirin, carbonic anhydrase inhibitors (e.g., acetazolamide), fruit juices, glutamic acid, guanethidine, methenamine, reserpine, sodium acid phosphate, sodium bicarbonate, certain "water pills" (diuretics, including some thiazides).
Also report the use of drugs which might increase seizure risk (decrease seizure threshold) when combined with this medication such as bupropion, isoniazid (INH), phenothiazines (e.g., thioridazine), theophylline, tramadol, or tricyclic antidepressants (e.g., amitriptyline), among others. Consult your doctor or pharmacist for details.
Check the labels on all your medicines (e.g., cough-and-cold products, diet aids) because they may contain ingredients that could increase your heart rate or blood pressure. Ask your pharmacist about the safe use of these products.
Avoid drinking large amounts of beverages containing caffeine (e.g., coffee, tea, colas) or eating large amounts of chocolate. Caffeine can increase the side effects of this medication.
This medication may affect the results of certain lab tests (blood and urine steroid levels). Tell your doctor or laboratory personnel if you are taking this medication.
This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.