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. Contact your doctor or health care professional if your symptoms get worse or if you have new symptoms.
You must have a weekly blood test when you first begin this medicine. If your blood counts stay in the right range for the first 6 months, the frequency of your test may then be reduced. Your name will go on a national registry of patients who take this medicine, to make sure that you have never had a serious reaction to it.
You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this drug 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.
If you notice an increased hunger or thirst, different from your normal hunger or thirst, or if you find that you have to urinate more frequently, you should contact your health care provider as soon as possible. You may need to have your blood sugar monitored. This medicine may cause changes in your blood sugar levels. You should monitor you blood sugar frequently if you have diabetes.
If you smoke, tell your doctor if you notice this medicine is not working well for you. Talk to your doctor if you are a smoker or if you decide to stop smoking.
If you are going to have surgery tell your doctor or health care professional that you are taking this medicine.
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.
Side Effects to watch for
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
- changes in vision
- chest pain, fast or irregular heartbeat
- difficulty sleeping, nightmares
- excessive thirst and/or hunger
- feeling faint or lightheaded, falls
- fever, chills, sore throat, or mouth sores
- muscle and joint aches and pains
- nausea, vomiting, or severe loss of appetite
- shortness of breath, chest pain, swelling in a leg
- stiffness, spasms, trembling
- trouble passing urine or change in the amount of urine
- trouble with balance, talking, walking
- uncontrollable tongue or chewing movements, smacking lips or puffing cheeks
- unusually weak or tired
- yellowing of the eyes, skin
Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):
What may interact with this drug?
Do not take this medicine with any of the following medications:
- certain medicines for fungal infections like fluconazole, itraconazole, ketoconazole, posaconazole, voriconazole
This medicine may also interact with the following medications:
- antihistamines for allergy, cough and cold
- birth control pills
- certain antibiotics like ciprofloxacin, erythromycin, mefloquine, moxifloxacin, pentamidine, rifabutin, rifampin
- certain medicines for bladder problems like oxybutynin, tolterodine
- certain medicines for blood pressure
- certain medicines for cancer
- certain medicines for depression, anxiety, or psychotic disturbances
- certain medicines for irregular heart beat like amiodarone, encainide, flecainide, propafenone, sotalol
- certain medicines for Parkinson's disease like benztropine, trihexyphenidyl
- certain medicines for seizures
- certain medicines for sleep
- certain medicines for stomach problems like cimetidine, dicyclomine, dolasetron, hyoscyamine
- certain medicines for travel sickness like scopolamine
- medicines that lower your chance of fighting infection
- other medicines that prolong the QT interval (cause an abnormal heart rhythm)
- skeletal muscle relaxants
- St. John's Wort