Common uses
This medicine is an antidepressant used to treat depression and anxiety. It may also be used to treat other conditions as determined by your doctor.

Before using
Do not take this medicine if you are also taking a monoamine oxidase inhibitor (maoi), fenfluramine, dexfenfluramine, sibutramine, or tramadol.

Additional monitoring of your dose or condition may be needed if you are taking cyproheptadine or lithium. Inform your doctor of any other medical conditions, allergies, pregnancy, or breast-feeding.

Directions
Follow the directions for using this medicine provided by your doctor. Swallow whole. Do not crush, break, chew, or place the medicine in water. If you have difficulty swallowing this medicine whole, the capsule may be opened and the contents sprinkled onto a spoonful of applesauce and taken as directed. Do not chew the food/medicine mixture. Swallow the mixture immediately. Follow each dose with a glass of cool water to ensure complete swallowing of the medicine.

Take this medicine with food or milk. Store this medicine at room temperature between 68 and 77 degrees f (20 and 25 degrees c) in a tightly-closed container, away from heat and light. Continue to take this medicine even if you feel better. Do not miss any doses. If you miss a dose of this medicine and you are taking 1 dose daily, take the missed dose if you remember the same day. Skip the missed dose if you do not remember until the next day. Do not take 2 doses at once.

Cautions
Do not take this medicine if you have had an allergic reaction to it or are allergic to any ingredient in this product. This medicine is not recommended for use in children or adolescents under 18 years of age. It is important that all patients, including those under 18, consult their doctor before stopping this medicine. Do not stop taking this medicine without first checking with your doctor. Keep all doctor and laboratory appointments while you are taking this medicine.

Additional monitoring of your condition is recommended at the start of treatment with this medicine and whenever a change to your dose is made. If you experience anxiety, agitation, panic attacks, difficulty sleeping, irritability, hostility, impulsive feelings, severe restlessness, or worsening of depression contact your doctor as soon as possible. These may be signs that your condition is worsening or that your treatment with this medicine should be evaluated. If you are a parent or caregiver of a patient that is taking this medicine, it is important for you to watch for these symptoms. Contact the doctor as soon as possible if any of these symptoms occur. Contact your doctor for more information.

This medicine may cause dizziness or drowsiness. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to this medicine. Using this medicine alone, with other medicines, or with alcohol may lessen your ability to drive or to perform other potentially dangerous tasks. This medicine will add to the effects of alcohol and other depressants. Ask your pharmacist if you have questions about which medicines are depressants.

Before you begin taking any new medicine, either prescription or over-the-counter, check with your doctor or pharmacist. This includes any medicine that contains dextromethorphan.

For women: if you plan on becoming pregnant, discuss with your doctor the benefits and risks of using this medicine during pregnancy, especially during the third trimester. It is unknown if this medicine is excreted in breast milk. If you are or will be breast-feeding while you are using this medicine, check with your doctor or pharmacist to discuss the risks to your baby.

Possible side effects
Side effects, that may go away during treatment, include drowsiness, dizziness, weakness, nausea, decreased appetite, dry mouth, constipation, change in sexual function, increased sweating, nervousness, or tremor. If they continue or are bothersome, check with your doctor.

Check with your doctor as soon as possible if you experience continuing headache, blurred vision, abnormal dreams or nightmares, or continued weight loss. Contact your doctor immmediatley if you experience mental or mood changes, thoughts of hurting yourself, or worsening depression. An allergic reaction to this medicine is unlikely, but seek immediate medical attention if it occurs. Symptoms of an allergic reaction include rash, itching, swelling, dizziness, or trouble breathing. If you notice other effects not listed above, contact your doctor, nurse, or pharmacist.

If you take too much
If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of overdose may include sleepiness, irregular heartbeat, and seizures.

Additional information
Do not share this medicine with others for whom it was not prescribed. Do not use this medicine for other health conditions. Keep this medicine out of the reach of children. If using this medicine for an extended period of time, obtain refills before your supply runs out

Drug interactions
Drug interactions can result in unwanted side effects or prevent a medicine from doing its job. Some medicines or medical conditions may interact with this medicine. Inform your doctor or pharmacist of all prescription and over-the-counter medicine that you are taking.