Buy Generic Seroquel

Drug Name

Seroquel (Quetiapine)

Drug Uses

Seroquel is used for treating schizophrenia. It is also used to treat acute manic episodes associated with bipolar disorder (manic-depression). It may also be used for other conditions as determined by your doctor.

How Taken

Use Seroquel as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Take Seroquel by mouth with or without food.

Taking Seroquel at the same time each day will help you remember to take it.

Take Seroquel on a regular schedule to get the most benefit from it.

It may take a few weeks for you to notice the benefits of Seroquel. Continue to take Seroquel even if you feel well. Do not miss any doses.

Drug Class and Mechanism

Seroquel is an antipsychotic. It works by altering the balance of certain chemicals that occur naturally in the brain, which are responsible for thinking and behavior.

Missed Dose

If you miss a dose of Seroquel , take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Storage

Store Seroquel at 77 degrees F (25 degrees C). Brief storage between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Seroquel out of the reach of children and away from pets.

Warnings/Precautions

Do not use Seroquel if: you are allergic to any ingredient in Seroquel.

Contact your doctor or health care provider right away if any of these apply to you.

Important:

Do not drive or perform other possibly unsafe tasks until you know how you react to it.

Do not become overheated in hot weather or while you are being active; heatstroke may occur.

Seroquel may raise your blood sugar. High blood sugar may make you feel confused, drowsy, or thirsty. It can also make you flush, breathe faster, or have a fruit-like breath odor. If these symptoms occur, tell your doctor right away.

Seroquel may rarely cause a prolonged, painful erection. This could happen even when you are not having sex. If this is not treated right away, it could lead to permanent sexual problems such as impotence. Contact your doctor right away if this happens.

Lab tests, including eye exams, blood glucose, and blood pressure, may be performed while you use Seroquel. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.

Use Seroquel with caution in the elderly; they may be more sensitive to its effects. Especially, dizziness and lightheadedness upon sitting or standing up.

Seroquel should not be used in children; safety and effectiveness in children have not been confirmed.

Pregnancy and breast-feeding: if you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Seroquel while you are pregnant. It is not known if Seroquel is found in breast milk. Do not breast-feed while taking Seroquel.

Possible Side Effects

Check with your doctor if any of these most common side effects persist or become bothersome:

• agitation;
• back pain;
• constipation;
• dizziness;
• drowsiness;
• dry mouth;
• headache;
• indigestion;
• runny nose;
• sore throat;
• stomach pain;
• weakness;
• weight gain.

Seek medical attention right away if any of these severe side effects occur:

• severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue);
• altered mental abilities, including lack of response to your surroundings;
• high blood sugar (eg, thirst, increased urination, confusion, drowsiness, flushing, rapid breathing, or fruity breath odor);
• increased or irregular heartbeat;
• involuntary, uncontrolled muscle movements;
• lightheadedness when rising from a seated or lying position;
• muscle stiffness;
• sweating;
• tremor;
• unexplained fever;
• vision changes.

More Information

Seroquel is to be used only by the patient for whom it is prescribed. Do not share it with other people.

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

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Amitriptyline is used for:

The relief of depression. It may also be used to treat chronic pain and other conditions as determined by your doctor.

Amitriptyline is a tricyclic antidepressant. How tricyclic antidepressants improve depression symptoms is not fully understood. They are thought to increase the activity of certain chemicals in the brain (norepinephrine, serotonin), which help improve mood.

Do NOT use Amitriptyline if:

• you are allergic to any ingredient in Amitriptyline
• you are currently taking or have taken a monoamine oxidase (MAO) inhibitor (eg, phenelzine, selegiline) within the last 14 days
• you are taking antihistamines (eg, diphenhydramine), cisapride, dofetilide, droperidol, fluoroquinolones (eg, ciprofloxacin), ketolides (eg, telithromycin) macrolides (eg, erythromycin), mibefradil, or pimozide
• you are recovering from a heart attack

Contact your doctor or health care provider right away if any of these apply to you.

Before using Amitriptyline :

Some medical conditions may interact with Amitriptyline. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have a history of mental illness (eg, bipolar disorder, mania, manic-depression), or have considered or attempted suicide
• if you have alcoholism or regularly consume 3 or more alcoholic beverages per day
• if you have glaucoma, an irregular heartbeat, heart disease, chest pain, liver disease, prostate problems, thyroid disease, or are unable to urinate (urinary retention)
• if you have a history of seizures, epilepsy, or porphyria

Some MEDICINES MAY INTERACT with Amitriptyline. Tell your health care provider if you are taking any other medicines, especially any of the following:

• MAO inhibitors (eg, phenelzine, selegiline) because they can cause serious, sometimes life-threatening, reactions. Do NOT take MAO inhibitors with, or within 2 weeks of taking, Amitriptyline
• Anticholinergics (eg, scopolamine), bupropion, cimetidine, fluconazole, phenothiazines (eg, chlorpromazine), SSRIs (eg, fluoxetine), terbinafine, or valproic acid because side effects such as blurred vision, difficult urination, drowsiness or sedation, dry mouth, or lightheadedness may occur
• Antihistamines (eg, diphenhydramine), cisapride, dofetilide, droperidol, fluoroquinolones (eg, ciprofloxacin), ketolides (eg, telithromycin), macrolides (eg, erythromycin), mibefradil, pimozide, or streptogramins (eg, quinupristin/dalfopristin) because serious side effects on the heart (eg, racing heartbeat, dizziness, fainting, life-threatening abnormal heartbeat leading to unconsciousness, and lack of heartbeat, may be increased by Amitriptyline
• Carbamazepine, thyroid medicines (eg, levothyroxine), or stimulants (eg, albuterol, pseudoephedrine) because their side effects may be increased by Amitriptyline
• Warfarin because side effects such as serious bleeding may be increased by Amitriptyline
• Clonidine, guanethidine, or guanfacine because the effectiveness of these medicines may be decreased

This may not be a complete list of all interactions that may occur. Ask your health care provider if Amitriptyline may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Amitriptyline :

Use Amitriptyline as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Amitriptyline comes with an additional patient information sheet called a Medication Guide. Read it carefully and reread it each time you get Amitriptyline refilled.
• Amitriptyline may be taken with food or on an empty stomach.
• Avoid eating or drinking grapefruit juice while taking Amitriptyline.
• Amitriptyline may take up to 30 days to control symptoms of depression. Continue to use Amitriptyline even if you feel well. Do not miss any doses.
• If you miss a dose of Amitriptyline , take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Amitriptyline.

Important safety information:

• Amitriptyline may cause dizziness, drowsiness, or blurred vision. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Amitriptyline. Using Amitriptyline alone, with other medicines, or with alcohol may lessen your ability to drive or perform other potentially dangerous tasks.
• Avoid drinking alcohol or taking other medicines that cause drowsiness (eg, sedatives, tranquilizers) while taking Amitriptyline. Amitriptyline will add to the effects of alcohol and other depressants. Ask your pharmacist if you have questions about which medicines are depressants.
• Alcoholic beverages, hot weather, exercise, and fever can increase dizziness. To prevent dizziness or fainting, sit up or stand slowly, especially in the morning. Also, sit or lie down at the first sign of dizziness or weakness.
• Involuntary and uncontrollable movements may develop in patients taking Amitriptyline. Occurrence is highest among the elderly, especially women. The risk of developing these involuntary movements and the likelihood they will become permanent are increased with long-term use and with high doses. However, it is possible to develop these symptoms after short-term use at low doses. Contact your health care provider at once if any of the following occur: involuntary movements of the tongue, face, mouth, or jaw (eg, protrusion of tongue, puffing of cheeks, puckering of mouth, chewing movements), sometimes accompanied by involuntary movements of the arms and legs.
• Amitriptyline may cause sensitivity to sunlight. Avoid prolonged exposure to the sun and other ultraviolet light (eg, tanning beds). Use sunscreens and wear protective clothing until tolerance is determined.
• Do not become overheated in hot weather or during exercise or other activities since heatstroke may occur.
• Before you have any medical or dental treatments, emergency care, or surgery, tell the doctor or dentist that you are using Amitriptyline.
• Use caution in the ELDERLY because they may be more sensitive to its effects, especially lightheadedness upon standing; rapid heartbeat; breathing problems; difficult urination; and constipation.
• PREGNANCY and BREAST-FEEDING: Amitriptyline has been shown to cause harm to the human fetus. If you plan on becoming pregnant, discuss with your doctor the benefits and risks of using this medicine during pregnancy. Amitriptyline is excreted in the breast milk. Do not breast-feed while taking Amitriptyline.

Possible side effects of Amitriptyline :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Abnormal skin sensations; anxiety; bad taste in mouth; black tongue; blurred vision; clumsiness; constipation; diarrhea; difficulty speaking or swallowing; dilation of the urinary tract; disturbed concentration; dizziness; drowsiness; dry mouth; excitement; fever; hair loss; headache; heartburn; hives; incoordination; increased pressure in the eye; inflammation of the tongue; irritability; itching; loss of appetite; mood swings; nausea; nightmares; numbness; rash; restlessness; ringing in the ears; sensitivity to sunlight; sleeplessness; sweating; swelling; swelling of the face and tongue; sore throat; tearing; tingling; tiredness; upset stomach; urinary retention; vomiting; weakness; weight gain.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); confusion; delusions; disorientation; fast heartbeat; fainting; hallucinations; involuntary movements of tongue, face, mouth, or jaw (eg, protrusion of tongue, puffing of cheeks, puckering of mouth, chewing movements), sometimes accompanied by involuntary movements of the arms and legs; lightheadedness; pounding in the chest; seizures; tremors; unusual bleeding or bruising; yellowing of the skin or eyes.

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

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Drug Name

Sarafem (Fluoxetine)

Drug Uses

This medicine is a selective serotonin reuptake inhibitor (SSRI) used to treat premenstrual dysphoric disorder (PMDD). It may also be used to treat other conditions as determined by your doctor.

How Taken

Take this medication by mouth usually once a day in the morning, with or without food, or as directed by your doctor. If your doctor tells you to take this medication twice a day, take a dose in the morning and at noon.

Dosage is based on your medical condition and response to therapy. Use this medication regularly in order to get the most benefit from it. Remember to use it at the same time(s) each day. It is important to continue taking this medication even if you feel well. Do not stop taking this medication without consulting your doctor. Do not take more or less medication than prescribed.

The maximum recommended dose for adults treated for obsessive-compulsive disorder and premenstrual dysphoric disorder is 80 mg per day. The maximum recommended dose for children with attention-deficit hyperactivity disorder (ADHD) treated for depression is 20 mg per day. It may take 4 weeks or longer before the full benefit of this drug takes effect. Inform your doctor if your condition persists or worsens.

Drug Class and Mechanism

Sarafem is a selective serotonin reuptake inhibitor (SSRI) used to treat depression, obsessive-compulsive disorder, panic attacks, certain eating disorders (bulimia), and a severe form of premenstrual syndrome (premenstrual dysphoric disorder or PMDD). This medication works by restoring the balance of natural substances (neurotransmitters) in the brain, thereby improving mood and feelings of well-being.

Missed Dose

If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Storage

Store at room temperature between 59-86 degrees F (15-30 degrees C), away from light and moisture. Do not store in the bathroom. Keep all medicines away from children and pets.

Warnings/Precautions

Before taking sarafem, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, kidney disease, stomach bleeding, diabetes, seizure disorder.

Though uncommon, depression can lead to thoughts or attempts of suicide. Tell your doctor immediately if you have any suicidal thoughts, worsening depression, or any other mental/mood changes (including new or worsening anxiety, agitation, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, rapid speech).

Keep all medical appointments so your healthcare professional can monitor your progress closely and adjust/change your medication if needed. If you have diabetes, sarafem may affect your blood glucose levels. Monitor your blood glucose regularly, and share the results with your doctor. The dose of your anti-diabetic medication(s) may need to be adjusted.

Liquid preparations of this product may contain sugar and/or small amounts of alcohol. Ask your doctor or pharmacist about the safe use of this product if you have diabetes. This drug may make you dizzy or drowsy; use caution engaging in activities requiring alertness such as driving or using machinery. Limit alcoholic beverages. Caution is advised when using this drug in the elderly because they may be more sensitive to its effects, especially drowsiness.

This medication should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor. If this medication is used during the last 3 months of pregnancy, infrequently your newborn may develop symptoms including feeding or breathing difficulties, seizures, muscle stiffness, jitteriness or constant crying.

However, do not stop taking this medication unless your doctor directs you to do so. Report any such symptoms to your doctor promptly. Sarafem passes into breast milk and may have undesirable effects on a nursing infant. Therefore, breast-feeding while taking this drug is not recommended. Consult your doctor before breast-feeding.

Possible Side Effects

Nausea, loss of appetite, diarrhea, dry mouth, trouble sleeping, dizziness, drowsiness, yawning, weakness, or sweating may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.

Tell your doctor immediately if any of these serious side effects occur:

• unusual or severe mental/mood changes (e.g., anxiety, mania),
• weight loss,
• change in sexual desire and ability,
• vision changes.

Tell your doctor immediately if any of these unlikely but serious side effects occur: uncontrolled movements (tremor), fever/flu-like symptoms.

Tell your doctor immediately if any of these highly unlikely but very serious side effects occur:

• unusual muscle stiffness,
• fast/irregular heartbeats,
• chest pain,
• black stools,
• vomit that looks like coffee grounds,
• easy bruising/bleeding,
• unusual bleeding,
• seizures.

For males, in the very unlikely event you have a painful, prolonged erection (lasting more than 4 hours), stop using this drug and seek immediate medical attention or permanent problems could occur. A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs.

Symptoms of a serious allergic reaction include:

• rash,
• itching,
• swelling,
• severe dizziness,
• trouble breathing.

If you notice other effects not listed above, contact your doctor or pharmacist.

More Information

Do not share this medicine with others for whom it was not prescribed. Do not use this medicine for other health conditions.

Keep this medicine out of the reach of children. If using this medicine for an extended period of time, obtain refills before your supply runs out.

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

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Venlafaxine is used for:

Treating depression. It may also be used for other conditions as determined by your doctor.

Venlafaxine is a serotonin and norepinephrine reuptake inhibitor (SNRI). It works by restoring the balance of certain natural substances in the brain (serotonin and norepinephrine), which helps to improve certain mood problems.

Do NOT use Venlafaxine if:

• you are allergic to any ingredient in Venlafaxine
• you are taking or have taken a monoamine oxidase inhibitor (MAOI) (eg, phenelzine), selegiline, or St. John’s wort within the last 14 days

• you are taking a fenfluramine derivative (eg, dexfenfluramine), nefazodone, sibutramine, or tryptophan

Contact your doctor or health care provider right away if any of these apply to you.

Before using Venlafaxine :

Some medical conditions may interact with Venlafaxine. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you or a family member has a history of bipolar disorder (manic-depression), other mental or mood problems, suicidal thoughts or attempts, or alcohol or substance abuse
• if you have a history of seizures, heart problems, (eg, heart failure, irregular heartbeat), abnormal electrocardiogram, recent heart attack, high blood pressure, overactive thyroid, liver problems, kidney problems, stomach or bowel bleeding, increased eye pressure (eg, glaucoma), nervous system problems, or metabolism problems
• if you are dehydrated, have low blood sodium levels, or drink alcohol
• if you will be having electroconvulsive therapy (ECT)

Some MEDICINES MAY INTERACT with Venlafaxine. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Certain diet medicines (eg, phentermine, fenfluramine), linezolid, lithium, MAOIs (eg, phenelzine), metoclopramine, nefazodone, selegiline, selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine) serotonin and norepinephrine reuptake inhibitors (SNRIs) (eg, duloxetine), serotonin 5-HT₁ receptor agonists (eg, sumatriptan), sibutramine,St. John’s wort, tramadol, trazodone, or tryptophan because severe side effects, such as a reaction that may include fever, rigid muscles, blood pressure changes, mental changes, confusion, irritability, agitation, delirium, and coma, may occur
• Nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen) because the risk of bleeding, including stomach bleeding, may be increased
• Diuretics (eg, furosemide, hydrochlorothiazide) because the risk of low blood sodium levels may be increased
• Cimetidine or ketoconazole because they may increase the risk of Venlafaxine ’s side effects
• Cyproheptadine because it may decrease Venlafaxine ’s effectiveness
• Aripiprazole, haloperidol, phenothiazines (eg, chlorpromazine, thioridazine), or risperidone because the risk of their side effects may be increased by Venlafaxine

This may not be a complete list of all interactions that may occur. Ask your health care provider if Venlafaxine may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Venlafaxine :

Use Venlafaxine as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Venlafaxine comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Venlafaxine refilled.
• Take Venlafaxine by mouth with food.
• Venlafaxine works best if it is taken at the same time each day.
• Continue to take Venlafaxine even if you feel well. Do not miss any doses.
• Do not suddenly stop taking Venlafaxine without checking with your doctor. Side effects may occur. They may include mental or mood changes, numbness or tingling of the skin, dizziness, drowsiness, confusion, headache, increased sweating, nausea, ringing in the ears, seizures, tremor, trouble sleeping, or unusual tiredness. You will be closely monitored when you start Venlafaxine and whenever a change in dose is made.
• If you miss a dose of Venlafaxine , take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Venlafaxine.

Important safety information:

• Venlafaxine may cause drowsiness, dizziness, or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Take Venlafaxine with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
• Do not drink alcohol while you are using Venlafaxine.
• Do not use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Venlafaxine without checking with your doctor; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
• Several weeks may pass before your symptoms improve. Do NOT take more than the recommended dose or use for longer than prescribed without checking with your doctor.
• Children and teenagers who take Venlafaxine may be at increased risk for suicidal thoughts or actions. Adults may also be affected. The risk may be greater in patients who have had suicidal thoughts or actions in the past. The risk may also be greater in patients who have had bipolar (manic-depressive) illness, or if a family member has had it. Watch patients who take Venlafaxine closely. Contact the doctor at once if new, worsened, or sudden symptoms, such as depressed mood; anxious, restless, or irritable behavior; panic attacks; or any unusual changes in mood or behavior, occur. Contact the doctor right away if any signs of suicidal thoughts or actions occur.
• Serotonin syndrome is a possibly fatal syndrome that can be caused by Venlafaxine. Your risk may be greater if you take Venlafaxine with certain other medicines (eg, “triptans,” MAOIs, SSRIs). Symptoms may include agitation; confusion; hallucinations; coma; fever; fast or irregular heartbeat; tremor; excessive sweating; and nausea, vomiting, or diarrhea. Contact your doctor at once if you have any of these symptoms.
• If your doctor tells you to stop taking Venlafaxine , you will need to wait for a period of time before beginning to take certain other medicines (eg, MAOIs, nefazodone, thioridazine). Ask your doctor when you should start to take your new medicines after you have stopped taking Venlafaxine.
• Venlafaxine may rarely cause a prolonged, painful erection. This could happen even when you are not having sex. If this is not treated right away, it could lead to permanent sexual problems such as impotence. Contact your doctor right away if this happens.
• Lab tests, including blood pressure and blood cholesterol levels, may be performed while you use Venlafaxine. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
• Use Venlafaxine with caution in the ELDERLY; they may be more sensitive to its effects, especially low blood sodium levels.
• Caution is advised when using Venlafaxine in CHILDREN; they may be more sensitive to its effects, especially increased risk of suicidal thoughts or actions.
• Venlafaxine should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.
• Venlafaxine may cause weight changes and growth changes. CHILDREN and teenagers may need regular weight and growth checks while they take Venlafaxine.
• PREGNANCY and BREAST-FEEDING: Venlafaxine may cause harm to the fetus if it is used during the last 3 months of pregnancy. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using this medicine while you are pregnant. Venlafaxine is found in breast milk. Do not breast-feed while taking Venlafaxine.

Possible side effects of Venlafaxine :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Anxiety; blurred vision; changes in taste; constipation; decreased sexual desire or ability; dizziness; drowsiness; dry mouth; flushing; headache; increased sweating; loss of appetite; nausea; nervousness; stomach upset; trouble sleeping; vomiting; weakness; weight loss; yawning.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bizarre behavior; chest pain or discomfort; confusion; decreased urination; fast or irregular heartbeat; fever, chills, or sore throat; new or worsening agitation, panic attacks, aggressiveness, impulsiveness, irritability, hostility, restlessness, or inability to sit still; persistent or severe ringing in the ears; seizures; severe or persistent anxiety, nervousness, or trouble sleeping; severe or persistent cough; severe or persistent headache, dizziness, or stomach pain; shortness of breath; significant weight loss; suicidal thoughts or attempts; tremor; unusual bruising or bleeding; unusual or severe mental or mood changes; vision problems; worsening of depression.

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

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What is/are Fluoxetine Tablets?

FLUOXETINE belongs to a class of drugs known as selective serotonin reuptake inhibitors (SSRIs). It helps to treat mood problems such as depression, obsessive compulsive disorder, and panic attacks. It can also treat certain eating disorders. This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

What should I tell my health care providers before I take this medicine?

They need to know if you have any of these conditions:

bipolar disorder or mania diabetes liver disease psychosis seizures suicidal thoughts or history of attempted suicide an unusual or allergic reaction to fluoxetine, other medicines, foods, dyes, or preservatives pregnant or trying to get pregnant breast-feeding

How should I use this medicine?

Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. You can take this medicine with or without food. Take your medicine at regular intervals. Do not take it more often than directed. Do not stop taking except on your doctor’s advice.

A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.

Talk to your pediatrician regarding the use of this medicine in children. While this drug may be prescribed for children as young as 7 years for selected conditions, precautions do apply.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

Note: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, skip the missed dose and go back to your regular dosing schedule. Do not take double or extra doses.

What may interact with this medicine?

Do not take fluoxetine with any of the following:

other medicines containing fluoxetine, like Sarafem or Symbyax certain diet drugs like dexfenfluramine, fenfluramine, phentermine cisapride medicines called MAO Inhibitors like Carbex, Eldepryl, Marplan, Nardil, and Parnate pimozide procarbazine St. John’s wort thioridazine tryptophan

Fluoxetine may also interact with the following:

alcohol any other medicines for depression, anxiety, or psychotic disturbances aspirin carbamazepine cyproheptadine dextromethorphan flecainide lithium medicines for diabetes medicines for migraine headache, like sumatriptan medicines for sleep metoprolol NSAIDs, medicines for pain and inflammation, like ibuprofen or naproxen phenytoin propafenone propranolol vinblastine warfarin

This list may not describe all possible interactions. Give your health care providers a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What side effects may I notice from this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue breathing problems confusion fast or irregular heart rate, palpitations flu-like fever, chills, cough, muscle or joint aches and pains seizures suicidal thoughts or other mood changes tremors trouble sleeping unusually tired or weak vomiting

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

blurred vision change in sex drive or performance diarrhea dry mouth flushing headache increased or decreased appetite nausea sweating

This list may not describe all possible side effects.

What should I watch for while using this medicine?

Visit your doctor or health care professional for regular checks on your progress. Continue to take your medicine even if you do not immediately feel better. It can take several weeks before you notice the full effect of this medicine.

Patients and their families should watch out for worsening depression or thoughts of suicide. Also watch out for any sudden or severe changes in feelings such as feeling anxious, agitated, panicky, irritable, hostile, aggressive, impulsive, severely restless, overly excited and hyperactive, or not being able to sleep. If this happens, especially at the beginning of treatment or after a change in dose, call your doctor.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol can make you more drowsy and dizzy. Avoid alcoholic drinks.

Your mouth may get dry. Chewing sugarless gum or sucking hard candy, and drinking plenty of water may help. Contact your doctor if the problem does not go away or is severe.

If you have diabetes, this medicine may affect blood sugar levels. Check your blood sugar. Talk to your doctor or health care professional if you notice changes.

If you have been taking this medicine regularly for some time, do not suddenly stop taking it. You must gradually reduce the dose or you may get side effects or have a worsening of your condition. Ask your doctor or health care professional for advice.

Do not treat yourself for coughs, colds or allergies without asking your doctor or health care professional for advice. Some ingredients can increase possible side effects. Where should I keep this medicine?

Keep out of the reach of children.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Throw away any unused medicine after the expiration date.

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

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Trazodone is used for:

Treating depression. It may also be used for relief of an anxiety disorder (eg, sleeplessness, tension), chronic pain. It may also be used for other conditions as determined by your doctor.

Trazodone is a tetracyclic antidepressant. It is thought to increase the activity of one of the brain chemicals (serotonin), which helps elevate mood.

Do NOT use Trazodone if:

• you are allergic to any ingredient in Trazodone or nefazodone
• you are taking sodium oxybate (GHB)

Contact your doctor or health care provider right away if any of these apply to you.

Before using Trazodone :

Some medical conditions may interact with Trazodone. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have heart disease including irregular heartbeat or have had a heart attack
• if you have a history of depression or suicidal tendencies
• if you are scheduled to have surgery
• if you consume alcoholic beverages

Some MEDICINES MAY INTERACT with Trazodone. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Carbamazepine, ethanol, ginkgo biloba, HIV protease inhibitors (eg, ritonavir), phenothiazines (eg, thioridazine), or serotonin reuptake inhibitors (eg, fluoxetine) because side effects, such as increased drowsiness or blurred vision, may occur
• Buspirone, carbamazepine, digoxin, hydantoins (eg, phenytoin), itraconazole, ketoconazole, nefazodone, serotonin reuptake inhibitors (eg, fluoxetine), or sodium oxybate (GHB) because the risk of their side effects may be increased by Trazodone
• Anticoagulants (eg, warfarin) because they may decrease Trazodone ’s effectiveness. Your doctor may want to adjust your dose while taking Trazodone

This may not be a complete list of all interactions that may occur. Ask your health care provider if Trazodone may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Trazodone :

Use Trazodone as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Trazodone comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Trazodone refilled.
• Take Trazodone shortly after a meal or light snack.
• It may take 1 to 4 weeks for Trazodone to work. Do not stop taking Trazodone without checking with your doctor.
• If a dose is missed, take it as soon as possible. If several hours have passed or if it is nearing time for the next dose, do not double the dose to catch up. If more than one dose is missed, restart medication and advise your doctor or pharmacist at your next appointment.

Ask your health care provider any questions you may have about how to use Trazodone.

Important safety information:

• Trazodone may cause drowsiness, dizziness, or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use Trazodone with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
• Do not drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Trazodone ; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
• Children and teenagers who take Trazodone may be at increased risk for suicidal thoughts or actions. Adults may also be affected. The risk may be greater in patients who have had suicidal thoughts or actions in the past. The risk may also be greater in patients who have had bipolar (manic-depressive) illness, or if their family members have had it. Watch patients who take Trazodone closely. Contact the doctor at once if new, worsened, or sudden symptoms such as depressed mood; anxious, restless, or irritable behavior; panic attacks; or any unusual change in mood or behavior occur. Contact the doctor right away if any signs of suicidal thoughts or actions occur.
• Tell your doctor or dentist that you take Trazodone before you receive any medical or dental care, emergency care, or surgery.
• Trazodone should not be used in CHILDREN younger than 6 years old; safety and effectiveness in these children have not been confirmed.
• Trazodone may rarely cause a prolonged, painful erection. This could happen even when you are not having sex. If this is not treated right away, it could lead to permanent sexual problems, such as impotence. Contact your doctor right away if this happens.
• PREGNANCY and BREAST-FEEDING: If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using Trazodone while you are pregnant. Trazodone is found in breast milk. If you are or will be breast-feeding while you use Trazodone , check with your doctor. Discuss any possible risks to your baby.

Possible side effects of Trazodone :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Blurred vision; constipation; decreased appetite; dizziness; drowsiness; dry mouth; general body discomfort; headache; incoordination; light-headedness; muscle aches/pains; nausea; nervousness; sleeplessness; stomach pain; stuffy nose; swelling of the skin; tiredness; tremors.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blood in urine; chest pain; fainting; hallucinations; irregular heartbeat; light-headedness when rising from a lying or seated position; prolonged, inappropriate, or painful erections; seizures; shortness of breath; stroke; vomiting.

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

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What is fluoxetine?

• Fluoxetine is an antidepressant in a group of drugs called selective serotonin reuptake inhibitors (SSRIs). Fluoxetine affects chemicals in the brain that may become unbalanced and cause depression, panic, anxiety, or obsessive-compulsive symptoms.
• Fluoxetine is used to treat major depressive disorder, bulimia nervosa (an eating disorder) obsessive-compulsive disorder, panic disorder, and premenstrual dysphoric disorder (PMDD).
• Fluoxetine may also be used for purposes other than those listed in this medication guide.

What should I discuss with my doctor before taking fluoxetine?

• You may have an increased risk of suicidal thoughts or behavior at the start of treatment with an antidepressant medication, especially if you are under 18 years old. Talk with your doctor about this risk.
• o not use fluoxetine if you are using any of the following drugs:
  • pimozide (Orap);
  • thioridazine (Mellaril); or
  • an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), or selegiline (Eldepryl, Emsam).
• Serious and sometimes fatal reactions can occur when these medicines are taken with fluoxetine. You must wait at least 14 days after stopping an MAO inhibitor before you can take fluoxetine. You must wait 5 weeks after stopping fluoxetine before you can take thioridazine (Mellaril).
• Before taking fluoxetine, tell your doctor if you have:
  • cirrhosis of the liver;
  • kidney disease;
  • diabetes;
  • seizures or epilepsy;
  • bipolar disorder (manic depression); or
  • a history of drug abuse or suicidal thoughts.
• If you have any of these conditions, you may not be able to use fluoxetine, or you may need a dosage adjustment or special tests during treatment.
• FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.
• Fluoxetine can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take fluoxetine?

• Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Your doctor may occasionally change your dose to make sure you get the best results from the medication.
• Do not break, chew, or open an extended-release capsule. Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking the pill would cause too much of the drug to be released at one time.
• Try to take the medicine at the same time each day.
• It may take 4 weeks or more for you to start feeling better. Do not stop using fluoxetine without first talking to your doctor. You may have unpleasant side effects if you stop taking this medication suddenly.
• To treat premenstrual dysphoric disorder, the usual dose of fluoxetine is once daily while you are having your period. You may also begin taking the medication 14 days before the anticipated start of your period. Follow your doctor’s directions carefully.
• Store fluoxetine at room temperature away from moisture and heat.

What happens if I miss a dose?

• Take the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and take the next one as directed. Do not take extra medicine to make up the missed dose.
• If you miss a dose of the drug weekly, take the missed dose as soon as you remember and take the next dose 7 days later. However, if it is almost time for the next regularly scheduled weekly dose, skip the missed dose and take the next one as directed. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

• Seek emergency medical attention if you think you have taken too much of this medication. Symptoms of a fluoxetine overdose may include nausea, vomiting, fever, sleepiness, rapid or uneven heartbeat, confusion, fainting, seizures, or coma.

What should I avoid while taking fluoxetine?

• Do not take fluoxetine together with thioridazine (Mellaril), isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate).
• Avoid drinking alcohol, which can increase some of the side effects of fluoxetine.
• Avoid using other medicines that make you sleepy (such as cold medicine, other pain medication, muscle relaxants). They can add to sleepiness caused by fluoxetine.
• Fluoxetine can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

What are the possible side effects of fluoxetine?

• Get emergency medical help if you have any of these signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
• Contact your doctor promptly if you have any of the following side effects, especially if they are new symptoms or if they get worse: mood changes, anxiety, panic attacks, trouble sleeping, irritability, agitation, aggressiveness, severe restlessness, mania (mental and/ or physical hyperactivity), thoughts of suicide or hurting yourself.
• Call your doctor at once if you have any of these serious side effects:
  • seizure (convulsions);
  • tremors, shivering, muscle stiffness or twitching;
  • a red, blistering, peeling skin rash;
  • unusual thoughts or behavior;
  • seizure (convulsions);
  • problems with balance or coordination; or
  • agitation, confusion, sweating, fast heartbeat.
• Other less serious side effects are more likely to occur, such as:
  • feeling anxious, nervous, restless, or unable to sit still;
  • drowsiness, dizziness, weakness;
  • sleep problems (insomnia);
  • runny nose, sore throat, headache, flu symptoms;
  • nausea, diarrhea, changes in appetite;
  • weight changes;
  • decreased sex drive, impotence, or difficulty having an orgasm; or
  • dry mouth, increased sweating.
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What drug(s) may interact with fluoxetine?

Fluoxetine has the potential to interact with a variety of medications, check with your healthcare professional. The following list contains some of these interactions.

Do not take fluoxetine with any of the following medications:

• astemizole (Hismanal®)
• cisapride (Propulsid®)
• pimozide (Orap®)
• terfenadine (Seldane®)
• thioridazine (Mellaril®)
• medicines called MAO inhibitors-phenelzine (Nardil®), tranylcypromine (Parnate®), isocarboxazid (Marplan®), selegiline (Eldepryl®)

Fluoxetine may also interact with the following medications:

• alcohol
• amphetamine
• aspirin
• benzodiazepines, commonly used for anxiety or sleeping problems, such as diazepam or alprazolam
• buspirone
• carbamazepine
• certain diet drugs (dexfenfluramine, fenfluramine, phentermine, sibutramine)
• certain medicines for migraine headache (almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan, dihydroergotamine, ergotamine, methysergide)
• cimetidine
• cyproheptadine
• dextroamphetamine
• dextromethorphan
• dofetilide
• ergonovine
• furazolidone
• linezolid
• lithium
• metoprolol
• medicines for diabetes
• medicines for mental depression
• medicines for mental problems or psychotic disturbances
• methylergonovine
• nonsteroidal antiinflammatory drugs (NSAIDs, like ibuprofen)
• phenytoin
• propafenone
• propranolol
• St. John’s wort
• warfarin

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

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What is/are Cymbalta?

DULOXETINE is an antidepressant. It is used to treat depression. It is also used to treat pain caused by complications of diabetes or pain caused by fibromyalgia. This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

What should I tell my health care providers before I take this medicine?

They need to know if you have any of these conditions:

• bipolar disorder or a family history of bipolar disorder
• kidney or liver disease
• narrow- angle glaucoma
• suicidal thoughts or a previous suicide attempt
• taken medicines called MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate within 14 days
• an unusual reaction to duloxetine, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I use this medicine?

Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. Do not cut, crush or chew this medicine. You can take this medicine with or without food. Take your medicine at regular intervals. Do not take your medicine more often than directed. If you have been taking this medicine regularly for some time, do not suddenly stop taking it. You must gradually reduce the dose, or your symptoms may get worse. Ask your doctor or health care professional for advice.

A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

Note: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medicine?

Do not take this medicine with any of the following:

• certain diet drugs like dexfenfluramine, fenfluramine, phentermine, sibutramine
• MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate
• nefazodone
• procarbazine
• SSRIs like citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline
• St. John’s Wort
• thioridazine
• tryptophan
• venlafaxine

This medicine may also interact with the following:

• certain antibiotics like ciprofloxacin and enoxacin
• cimetidine
• medicines for heart rhythm or blood pressure
• other medicines for mental depression, mania, psychosis, or anxiety

This list may not describe all possible interactions. Give your health care providers a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What side effects may I notice from this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
• changes in blood pressure
• confusion
• dizziness
• fast talking and excited feelings or actions that are out of control
• fast, irregular heartbeat
• fever
• hallucination, loss of contact with reality
• seizures
• stomach flu-like symptoms of diarrhea, vomiting
• suicidal thoughts or other mood changes

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• blurred vision
• change in appetite
• change in sex drive or performance
• headache
• increased sweating
• nausea

This list may not describe all possible side effects.

What should I watch for while using this medicine?

Visit your doctor or health care professional for regular checks on your progress. Continue to take your medicine even if you do not feel better right away. It can take about 4 weeks before you feel the full effect of this medicine.

Patients and their families should watch out for worsening depression or thoughts of suicide. Also watch out for sudden or severe changes in feelings such as feeling anxious, agitated, panicky, irritable, hostile, aggressive, impulsive, severely restless, overly excited and hyperactive, or not being able to sleep. If this happens, especially at the beginning of treatment or after a change in dose, call your health care professional.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may interfere with the effect of this medicine. Avoid alcoholic drinks.

Do not treat yourself for coughs, colds, or allergies without asking your doctor or health care professional for advice. Some ingredients can increase possible side effects.

Your mouth may get dry. Chewing sugarless gum or sucking hard candy, and drinking plenty of water may help. Contact your doctor if the problem does not go away or is severe.

This medicine may cause an increase in blood pressure. Check with your doctor or health care professional, you may be able to measure your own blood pressure and pulse. Find out what your blood pressure and heart rate should be and when you should contact him or her.

Where should I keep this medicine?

Keep out of the reach of children.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Throw away any unused medicine after the expiration date. ,

What is/are Cymbalta?

DULOXETINE is an antidepressant. It is used to treat depression. It is also used to treat pain caused by complications of diabetes or pain caused by fibromyalgia. This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

What should I tell my health care providers before I take this medicine?

They need to know if you have any of these conditions:

• bipolar disorder or a family history of bipolar disorder
• kidney or liver disease
• narrow- angle glaucoma
• suicidal thoughts or a previous suicide attempt
• taken medicines called MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate within 14 days
• an unusual reaction to duloxetine, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I use this medicine?

Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. Do not cut, crush or chew this medicine. You can take this medicine with or without food. Take your medicine at regular intervals. Do not take your medicine more often than directed. If you have been taking this medicine regularly for some time, do not suddenly stop taking it. You must gradually reduce the dose, or your symptoms may get worse. Ask your doctor or health care professional for advice.

A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

Note: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medicine?

Do not take this medicine with any of the following:

• certain diet drugs like dexfenfluramine, fenfluramine, phentermine, sibutramine
• MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate
• nefazodone
• procarbazine
• SSRIs like citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline
• St. John’s Wort
• thioridazine
• tryptophan
• venlafaxine

This medicine may also interact with the following:

• certain antibiotics like ciprofloxacin and enoxacin
• cimetidine
• medicines for heart rhythm or blood pressure
• other medicines for mental depression, mania, psychosis, or anxiety

This list may not describe all possible interactions. Give your health care providers a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What side effects may I notice from this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
• changes in blood pressure
• confusion
• dizziness
• fast talking and excited feelings or actions that are out of control
• fast, irregular heartbeat
• fever
• hallucination, loss of contact with reality
• seizures
• stomach flu-like symptoms of diarrhea, vomiting
• suicidal thoughts or other mood changes

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• blurred vision
• change in appetite
• change in sex drive or performance
• headache
• increased sweating
• nausea

This list may not describe all possible side effects.

What should I watch for while using this medicine?

Visit your doctor or health care professional for regular checks on your progress. Continue to take your medicine even if you do not feel better right away. It can take about 4 weeks before you feel the full effect of this medicine.

Patients and their families should watch out for worsening depression or thoughts of suicide. Also watch out for sudden or severe changes in feelings such as feeling anxious, agitated, panicky, irritable, hostile, aggressive, impulsive, severely restless, overly excited and hyperactive, or not being able to sleep. If this happens, especially at the beginning of treatment or after a change in dose, call your health care professional.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may interfere with the effect of this medicine. Avoid alcoholic drinks.

Do not treat yourself for coughs, colds, or allergies without asking your doctor or health care professional for advice. Some ingredients can increase possible side effects.

Your mouth may get dry. Chewing sugarless gum or sucking hard candy, and drinking plenty of water may help. Contact your doctor if the problem does not go away or is severe.

This medicine may cause an increase in blood pressure. Check with your doctor or health care professional, you may be able to measure your own blood pressure and pulse. Find out what your blood pressure and heart rate should be and when you should contact him or her.

Where should I keep this medicine?

Keep out of the reach of children.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Throw away any unused medicine after the expiration date.

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

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What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

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Citalopram is used for:

Treating depression. It may also be used for other conditions as determined by your doctor.

Citalopram is a selective serotonin reuptake inhibitor (SSRI). It helps to restore the brain’s chemical balance by increasing the supply of serotonin, which helps improve mood.

Do NOT use Citalopram if:

• you are allergic to any ingredient in Citalopram
• you are taking or have taken a monoamine oxidase (MAO) inhibitor (eg, phenelzine) or St. John’s wort within the last 14 days
• you are taking astemizole, pimozide, dexfenfluramine, fenfluramine, phenothiazines (eg, thioridazine), sibutramine, or terfenadine

Contact your doctor or health care provider right away if any of these apply to you.

Before using Citalopram :

Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have suicidal tendencies or have attempted suicide, liver or kidney disease, stomach bleeding, seizures, or mania

Some MEDICINES MAY INTERACT with Citalopram. Tell your health care provider if you are taking any other medicines (especially any of the following):

• Cyproheptadine or risperidone because the effectiveness of Citalopram may be decreased
• Anorexiants (eg, phentermine), linezolid, lithium, or sumatriptan because side effects such as irritability or altered consciousness may occur
• Clozapine, H₁ antagonists (eg, diphenhydramine), metoclopramide, phenothiazines (eg, thioridazine), risperidone, or trazodone because the actions and side effects of these medicines may be increased
• Sumatriptan because the effectiveness of Citalopram may be decreased
• Anticoagulants (eg, warfarin), aspirin, or nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen) because of increased risk of bleeding of the stomach and bowels
• Fenfluramine and derivatives, MAO inhibitors (eg, phenelzine), selegiline, sibutramine, St. John’s wort, and tramadol because the actions and side effects, such as irritability or altered consciousness, of these medicines may be increased
• Pimozide because the risk of a change in heart rhythm may be increased

This may not be a complete list of all interactions that may occur. Ask your health care provider if Citalopram may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Citalopram :

Use Citalopram as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Citalopram comes with an additional patient information sheet called a Medication Guide. Read it carefully and reread it each time you get Citalopram refilled.
• Citalopram may be taken with or without food.
• You may notice improvement in your depression in 1 to 4 weeks. Continue to take your medicine as directed even when depression improves.
• If it is necessary to stop Citalopram , your doctor will need to reduce the dosage over a few days to a week.
• Do not miss any doses. If you miss a dose of Citalopram , skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Citalopram.

Important safety information:

• Citalopram may cause dizziness or drowsiness. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Citalopram. Using Citalopram alone, with other medicines, or with alcohol may lessen your ability to drive or perform other potentially dangerous tasks.
• If you experience a worsening of your symptoms (anxiety, agitation, insomnia, irritability, restlessness, or suicidal thinking) contact your doctor immediately.
• Citalopram will add to the effects of alcohol and other depressants. Ask your pharmacist if you have questions about which medicines are depressants.
• Additional monitoring of your condition is recommended at the start of treatment with Citalopram and whenever a change in your dose is made.
• LAB TESTS may be performed to monitor your progress. Be sure to keep all doctor and lab appointments.
• Citalopram is not recommended for use in CHILDREN. Safety and effectiveness have not been confirmed.
• PREGNANCY and BREAST-FEEDING: Citalopram has been shown to cause harm to the human fetus. If you become pregnant, discuss with your doctor the benefits and risks of using Citalopram during pregnancy. If you are pregnant, talk with your doctor about gradually decreasing your dose during the last trimester of pregnancy. Citalopram is excreted in breast milk. Do not breast-feed while taking Citalopram.

Possible side effects of Citalopram :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Change in taste; decreased menstrual flow or painful periods; diarrhea; dry mouth; ejaculation disorder; impotence; increased sweating; loss of appetite; nausea; runny nose; sinus inflammation; tiredness; tremor; upset stomach; weight loss or gain.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); anxiety; cold sweat; confusion; dizziness; fatigue; hostility; impulsiveness; irritability; lack of concern; mania; mental/mood changes; panic attacks; restlessness; seizures; shakiness; sleeplessness; sore throat or fever; suicidal thoughts or behaviors; vision changes; worsening of depression.

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

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