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Please be informed about the critical safety information and precautions associated with this medication to ensure its safe and effective use:

• Drug Interactions: Combining this medication with specific MAO inhibitors can result in a severe, potentially fatal reaction. It is crucial to avoid using isocarboxazid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, or tranylcypromine while on this medication. Additionally, refrain from using most MAO inhibitors for at least two weeks before initiating treatment. Consult your healthcare provider for guidance on when to begin or discontinue this medication.

• Other Medications and Substances: Inform your doctor or pharmacist if you are using other substances that could induce drowsiness. These include opioid pain or cough medications (e.g., codeine, hydrocodone), alcohol, marijuana (cannabis), sleep or anxiety medications (e.g., alprazolam, lorazepam, zolpidem), muscle relaxants (e.g., carisoprodol, cyclobenzaprine), or antihistamines (e.g., cetirizine, diphenhydramine).

• Label Awareness: Carefully examine labels on all your medications, including those for allergies or cough-and-cold, as they may contain ingredients similar to this medication or substances that cause drowsiness. Consult your pharmacist to ensure safe use of these products.

• Lab Test Interference: This medication may interfere with certain laboratory tests, such as urine drug screenings and allergy skin tests, potentially leading to incorrect results. It is important to inform laboratory personnel and all healthcare providers that you are using this medication.

These guidelines are provided to help you use the medication safely. If you have any questions or concerns, please contact your healthcare provider.

Common side effects:

• Drowsiness
• Dizziness
• Blurred vision
• Nausea
• Vomiting
• Difficulty sleeping
• Headaches

Serious side effects:

• Fast, irregular, or pounding heartbeat
• Confusion
• Hallucinations
• Nervousness
• Seizures
• Tremors
• Difficulty urinating
• Severe allergic reaction (rash, itching or swelling, particularly on the face, tongue, or throat, severe dizziness, or difficulty breathing)

Interactions with high risk of serious adverse effects and should be avoided:

• isocarboxazid
• Metaxalone
• methylene blue
• moclobemide
• phenelzine
• procarbazine
• Rasagiline
• safinamide
• Selegiline
• Tranylcypromine

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• opioid pain relievers (such as codeine, hydrocodone)
• alcohol
• marijuana (cannabis)
• sleep or anxiety drugs (such as Alprazolam, Lorazepam, Zolpidem)
• muscle relaxants (such as Carisoprodol, Cyclobenzaprine)
• other antihistamines (such as Cetirizine, diphenhydramine)