What should I watch for?
Visit your doctor or health care professional for regular checks on your progress. It may be several weeks before you see the full effects of this medicine.
Your health care provider may suggest that you have your eyes examined prior to starting this medicine, and every 6 months thereafter.
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.
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 antidepressant treatment or after a change in dose, call your health care professional.
You may get dizzy or drowsy. 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 increase dizziness and drowsiness. Avoid alcoholic drinks.
This medicine can reduce the response of your body to heat or cold. Dress warm in cold weather and stay hydrated in hot weather. If possible, avoid extreme temperatures like saunas, hot tubs, very hot or cold showers, or activities that can cause dehydration such as vigorous exercise.
Common and Rare Side Effects
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
sleepiness or unusual drowsiness
Black, tarry stools
changes in patterns and rhythms of speech
inability to move the eyes
inability to sit still
increased blinking or spasms of the eyelid
lip smacking or puckering
loss of balance control
need to keep moving
painful or difficult urination
puffing of the cheeks
rapid or worm-like movements of the tongue
shakiness in the legs, arms, hands, or feet
sores, ulcers, or white spots on the lips or in the mouth
sticking out of the tongue
stiffness of the arms or legs
swelling of the face, arms, hands, feet, or lower legs
trembling and shaking of the hands and fingers
trouble with breathing, speaking, or swallowing
uncontrolled chewing movements
uncontrolled movements of the arms and legs
uncontrolled twisting movements of the neck, trunk, arms, or legs
unusual bleeding or bruising
unusual facial expressions
unusual tiredness or weakness
Dry, puffy skin
fast, pounding, or irregular heartbeat
loss of appetite
unusual secretion of milk (in females)
Incidence not known
Aching or discomfort in the lower legs or sensation of crawling in the legs
painful or prolonged erection of the penis
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
tightness in the chest
tingling of the hands or feet
unusual weight gain or loss
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.