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This medication comes with important safety warnings that must be understood to ensure safe usage. Please follow these guidelines and consult your healthcare provider if you have any concerns or questions.

• Do Not Abruptly Stop Medication: Discontinuing this drug suddenly can exacerbate your condition, particularly if you suffer from chest pain, heart disease, or high blood pressure. Always consult your doctor before making changes to your medication regimen. If discontinuation is necessary, your doctor will provide a plan to gradually reduce the dose to prevent complications. During this process, reduce physical activity to minimize heart stress. Seek immediate medical attention if you experience symptoms like worsening chest pain, pain radiating to the jaw, neck, or arm, unusual sweating, difficulty breathing, or an irregular heartbeat.

• Heart Health Risks: Stopping the medication suddenly can increase the risk of heart attack or aggravate chest pain. Symptoms of a heart attack include chest pain, tightness, pain spreading to the arms and neck, shortness of breath, and fatigue. If you have coronary artery disease, consult your doctor about safely tapering off the medication.

• Heart Failure Concerns: Those with heart failure should only use this medication if their symptoms are well controlled, as it can potentially worsen the condition. Alert your healthcare provider if you notice symptoms of heart failure, such as fluid accumulation in the body and difficulty breathing.

• Blood Sugar Levels: This medication may obscure the symptoms of low blood sugar, such as a rapid heartbeat or tremors. If you are being treated for diabetes, monitor your blood sugar levels closely and consult with your healthcare provider on effective monitoring techniques.

• Thyroid Conditions: For individuals with hyperthyroidism, stopping this medication without medical advice can lead to severe symptoms, known as a "thyroid storm," characterized by high fever and rapid heartbeat. Discuss any changes with your doctor.

• Respiratory Issues: People with asthma, COPD, or other lung conditions should inform their doctor before using this medication, as it may constrict lung vessels and affect breathing.

• Skin Reactions: Rarely, this medication can cause severe skin reactions. If you develop a sudden rash, contact your healthcare provider immediately.

• Surgical Considerations: If you are scheduled for surgery requiring anesthesia, inform your surgeon about your medication use. Beta-blockers, in combination with anesthesia, can significantly lower heart rate.

Contraindications: This medication should not be used if you have conditions such as cardiogenic shock, sinus bradycardia, certain types of heart block, or bronchial asthma. Consult with your healthcare provider if these conditions apply to you before starting the medication.

Common side effects:

• dizziness
• lightheadedness
• tiredness
• feeling weak
• nausea
• vomiting
• stomach pain
• constipation
• diarrhea
• dry eyes
• trouble sleeping
• experiencing unusual dreams
• cold hands and feet

Less common but important to monitor:

• decreased sexual ability
• increased thirst or urination
• easy bruising or bleeding

Serious side effects:

• shortness of breath
• rapid weight gain
• swelling of the legs, ankles, or feet
• chest pain
• bronchospasm
• tightness in the chest
• difficulty breathing
• wheezing
• mental or mood changes, such as depression
• numbness or tingling in the arms or legs
• very slow heartbeat
• fainting
• rash
• itching
• swelling, particularly of the face, tongue, or throat
• severe dizziness
• trouble breathing
• severe skin reaction, such as rash, blistering, or peeling, accompanied by fever

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

• Thioridazine

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

• Epinephrine
• Fingolimod
• Albuterol
• Clonidine
• Diltiazem
• Verapamil
• Quinidine
• Rifamycins (such as Rifabutin)
• Fezolinetant
• Propafenone

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

• Ibuprofen
• Naproxen