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When taking this medication, you might experience some common side effects such as diarrhea, nausea, vomiting, dizziness, drowsiness, and stomach upset. It's also possible to notice a loss of appetite, trouble sleeping, headaches, or a dry mouth. These side effects are generally mild and often temporary. However, if they persist or worsen, it's important to inform your healthcare provider. An interesting, non-harmful effect is that your saliva, urine, or sweat may darken, which can stain clothing.

Some individuals may experience increased sleepiness or even fall asleep suddenly during regular activities like talking or driving, sometimes without prior drowsiness. If this occurs, refrain from driving or engaging in potentially dangerous activities until you consult with your doctor, as alcohol or other drowsiness-inducing medications can heighten this risk.

Serious side effects are less common but require prompt medical attention. These include uncontrollable movements or spasms, severe eye blinking or twitching, persistent diarrhea, vision changes, severe stomach pain, black stools, coffee ground-like vomit, muscle pain, signs of kidney problems, mood changes, persistent sore throat, easy bruising, or unusual urges. In rare cases, very serious side effects like chest pain or fainting may occur, as well as a risk of neuroleptic malignant syndrome (NMS) if the medication is abruptly stopped. Symptoms of NMS include fever, muscle stiffness, severe confusion, sweating, and irregular heartbeat.

A severe allergic reaction is also rare but serious. Seek immediate medical help if you notice symptoms such as a rash, itching or swelling, severe dizziness, or difficulty breathing. While this list covers many potential side effects, it is not exhaustive. Always contact your healthcare provider if you experience any other unusual symptoms.

Some medications that might interact with this drug include specific treatments for high blood pressure, such as methyldopa. It's important to avoid using MAO inhibitors (like isocarboxazid, linezolid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, and tranylcypromine) while taking this medication, as it may lead to a serious, potentially life-threatening reaction. Most MAO inhibitors should be discontinued for at least two weeks before starting this medication. However, some MAO inhibitors like rasagiline, safinamide, and selegiline can be used, but only under careful monitoring by your doctor. Consult your doctor regarding when to begin or stop this medication.

Inform your doctor or pharmacist if you are using other substances that can cause drowsiness, including alcohol, marijuana (cannabis), antihistamines (such as cetirizine and diphenhydramine), sleep or anxiety medications (such as alprazolam, diazepam, and zolpidem), muscle relaxants (such as carisoprodol and cyclobenzaprine), and opioid pain relievers (such as codeine and hydrocodone).

Be sure to check the labels on all your medications, including those for allergies or cough and cold, as they may contain ingredients that can cause drowsiness. Consult your pharmacist to ensure these products are used safely. Additionally, this medication may affect certain laboratory tests, such as urine catecholamine, glucose, or ketone tests, potentially leading to inaccurate results. Ensure that all medical personnel and your doctors are aware that you are using this medication.