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When using this medication, it is important to be aware of potential interactions with other substances. Here are some key considerations:

• Drug Interactions: Be cautious if you are taking medications such as blood thinners (e.g., warfarin, heparin), blood pressure drugs (especially nifedipine), immune system affecting drugs (like azathioprine, cyclosporine, prednisone), and fluvoxamine. Additionally, products containing caffeine (such as coffee, tea, and certain sodas) may interact with this medication.

• Substances Causing Drowsiness: Inform your healthcare provider if you are using other substances that may induce drowsiness, including opioid pain or cough relievers (like codeine, hydrocodone), alcohol, marijuana (cannabis), sleep or anxiety medications (such as alprazolam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (like cetirizine, diphenhydramine).

• Checking Medication Labels: Always check the labels of all your medications, including those for allergies or cough-and-cold, as they may contain ingredients that cause drowsiness. Consult your pharmacist to ensure safe usage of these products.

By adhering to these guidelines, you can help minimize potential risks and ensure the safe use of this medication.

Common side effects:

• Headache
• Dizziness
• Shaking
• Nausea
• Abdominal cramps
• Drowsiness
• Reduced alertness

Less common but important to monitor:

• Daytime drowsiness affecting daily activities

Serious side effects:

• Mental or mood changes like depression or confusion
• Rash
• Itching or swelling (particularly of the face, tongue, or throat)
• Severe dizziness
• Difficulty breathing

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

• Warfarin
• heparin
• nifedipine

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

• Azathioprine
• Cyclosporine
• Prednisone
• Fluvoxamine

Interactions with low risk that usually do not require a change in therapy:

• Caffeine (coffee, tea, some sodas)
• opioid pain or cough relievers (codeine, hydrocodone)
• alcohol
• marijuana (cannabis)
• sleep or anxiety medications (Alprazolam, Lorazepam, Zolpidem)
• muscle relaxants (Carisoprodol, Cyclobenzaprine)
• antihistamines (Cetirizine, diphenhydramine)