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This medication requires careful management due to potential risks of abuse and addiction, which can result in overdose and even death. Additionally, it may cause severe, potentially fatal breathing complications. To minimize these risks, your healthcare provider should prescribe the smallest effective dose for the shortest duration necessary.

• Breathing Risks: The likelihood of severe breathing issues increases when starting this medication or if taken incorrectly or in excess. Combining it with alcohol or other substances that induce drowsiness or breathing difficulties can lead to serious, possibly lethal, side effects.

• Drug Interactions: Be cautious of other medications that may interfere with how this drug is metabolized, impacting its effectiveness. Know the medications to avoid while using this product.

• Emergency Symptoms: Seek immediate medical attention if you experience symptoms such as slow or shallow breathing, extreme lightheadedness, severe drowsiness or dizziness, or difficulty waking up.

• Storage and Safety: Store this medication securely to prevent theft, misuse, or accidental ingestion. In case of accidental consumption, obtain medical help immediately.

Before using this medication, women of childbearing age should discuss potential risks and benefits with their healthcare provider. This medication is not recommended during pregnancy, especially in the first two months, due to a slight increase in the risk of birth defects and potential harm to the unborn if used in high doses near delivery. Newborns exposed to this medication for a prolonged period may show severe withdrawal symptoms, requiring immediate medical attention. Symptoms to watch for include persistent crying, slow or shallow breathing, irritability, shaking, vomiting, diarrhea, poor feeding, or difficulty gaining weight.

Additional Precautions:

• Drowsiness and Alertness: This drug can cause significant drowsiness, affecting concentration and reaction times. This effect is heightened in individuals over 65, those consuming alcohol, or using other sedatives. Avoid driving or operating heavy machinery until you understand how this medication affects you.

• Exacerbation of Conditions: Do not use this medication if you have specific health conditions unless advised by your healthcare provider. It can aggravate existing conditions such as respiratory issues, heart disease, high blood pressure, diabetes, thyroid disorders, glaucoma, and urinary problems. Discuss your complete medical history with your provider before starting treatment.

Contraindications: Avoid using this medication if you have taken an MAOI within the last two weeks, as this can lead to serious health complications. Always consult your healthcare provider if you have any concerns or questions regarding this medication.

When using this medication, some individuals may experience mild side effects such as drowsiness, dizziness, headache, blurred vision, upset stomach, nausea, constipation, and dry mouth, nose, or throat. These common side effects are usually not severe and can often be managed by drinking water, chewing sugarless gum, or using saliva substitutes for dry mouth. If these effects persist or worsen, it's advisable to consult your healthcare provider.

It's important to be aware of more serious side effects, although they are rare. These include interrupted breathing during sleep (sleep apnea), mental or mood changes like hallucinations, ringing in the ears, tremors, trouble urinating, weakness, easy bruising or bleeding, and irregular heartbeat. Additionally, this medication can lead to serious, possibly fatal, breathing problems and severe allergic reactions. Symptoms of an allergic reaction can include rash, itching, swelling, severe dizziness, and difficulty breathing. Seek medical help immediately if you experience any of these symptoms.

In rare cases, the medication may contain codeine or dihydrocodeine, which can transform into strong opioids in the body, increasing the risk of severe side effects like slow or shallow breathing, extreme drowsiness, or confusion. If these occur, seek emergency medical attention promptly. Always reach out to your healthcare provider if you notice any side effects not listed here.

Certain products can interact with this medication, affecting its efficacy or causing harmful side effects. Antihistamines applied to the skin, such as diphenhydramine cream, ointment, or spray, as well as medications like naltrexone and samidorphan, may interact with this drug. Importantly, taking monoamine oxidase (MAO) inhibitors, such as isocarboxazid, linezolid, or tranylcypromine, alongside this medication can lead to a severe, potentially life-threatening interaction. It is crucial to avoid MAO inhibitors during and for two weeks before starting treatment. Consult your healthcare provider for guidance on when to begin or discontinue use.

The risk of serious side effects, including slow or shallow breathing and intense drowsiness, increases if this medication is combined with other substances causing drowsiness or respiratory issues. These include opioid pain or cough medications like codeine or hydrocodone, alcohol, marijuana, sleep or anxiety drugs such as alprazolam or lorazepam, muscle relaxants like carisoprodol, and other antihistamines such as cetirizine. Ensure that you inform your doctor or pharmacist about all the products you are using, including over-the-counter medications that might cause drowsiness.

Additionally, some medications can alter how this drug is processed in your body, potentially affecting its performance. These include azole antifungals (e.g., ketoconazole), bupropion, fluoxetine, macrolide antibiotics (e.g., erythromycin), paroxetine, quinidine, rifamycins (e.g., rifampin), ritonavir, and certain seizure treatments like carbamazepine.

Be aware that this medication might interfere with specific lab tests, possibly leading to inaccurate results. Inform all medical personnel involved in your care that you are taking this drug.