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When using this medication, it is important to be aware of potential interactions and risks to ensure safe and effective treatment. Below are key safety guidelines and warnings to consider:

• Drug Interactions:

  • Avoid combining this medication with sodium oxybate as it may lead to interactions.
  • MAO inhibitors, such as isocarboxazid, linezolid, and others, can cause severe and possibly fatal interactions if taken with this medication. These should not be used during treatment and typically should be avoided for two weeks before and after therapy. Consult your healthcare provider for specific timing.

• Serotonin Syndrome Risk:

  • The likelihood of serotonin syndrome or toxicity increases if you are concurrently taking drugs that elevate serotonin levels. This includes certain street drugs like MDMA, herbal supplements like St. John's wort, and specific antidepressants such as SSRIs (e.g., fluoxetine, paroxetine) and SNRIs (e.g., duloxetine, venlafaxine). The risk is heightened when initiating or increasing doses of these substances.

• Caution with Drowsiness-Inducing Products:

  • Inform your physician or pharmacist if you are using other products that may cause drowsiness. These include opioid pain or cough medications (e.g., codeine, hydrocodone), alcohol, marijuana, sleep or anxiety drugs (e.g., alprazolam, lorazepam, zolpidem), muscle relaxants (e.g., carisoprodol, cyclobenzaprine), and some antihistamines (e.g., cetirizine, diphenhydramine).
  • Carefully read the labels of all your medications, including those for allergies or cold symptoms, as they may contain ingredients that induce drowsiness. Consult your pharmacist for advice on safe usage.

Always follow your healthcare provider's instructions and report any unusual symptoms or concerns during your treatment.

Common side effects:

• nausea
• loss of appetite
• dizziness
• drowsiness
• headache
• dry mouth

Less common but important to monitor:

• muscle stiffness or spasms
• severe muscle aches
• unusual or inappropriate sexual urges
• tremors
• unusual weakness

Serious side effects:

• serotonin syndrome
• serious allergic reaction

This medication may interact with sodium oxybate and should not be combined with MAO inhibitors due to the risk of severe, potentially fatal reactions. Avoid taking MAO inhibitors such as isocarboxazid, linezolid, and others listed, during and for two weeks before and after treatment with this drug. Consult your doctor for guidance on when to begin or discontinue this medication.

Additionally, the likelihood of serotonin syndrome or toxicity is heightened if you are using other substances that increase serotonin levels. These include certain street drugs like MDMA, herbal supplements like St. John's wort, and specific antidepressants, including SSRIs (e.g., Fluoxetine, paroxetine) and SNRIs (e.g., Duloxetine, Venlafaxine). This risk may be more pronounced when starting or increasing the dose of these medications.

Inform your healthcare provider if you are taking other products that induce drowsiness, such as opioid pain or cough medications (e.g., codeine, Hydrocodone), alcohol, marijuana, sleep or anxiety medications (e.g., Alprazolam, Lorazepam, Zolpidem), muscle relaxants (e.g., Carisoprodol, Cyclobenzaprine), or antihistamines (e.g., Cetirizine, diphenhydramine). Review the labels of all your medications, including those for allergies or colds, as they may contain ingredients that cause drowsiness. Consult your pharmacist on the safe use of these products.