When This Medicine Should Not Be Used:
You should not use this medicine if you have had an allergic reaction to any of the ingredients. You should not use this medicine if you are also using an MAO inhibitor (MAOI) such as Eldepryl®, Marplan®, Nardil®, or Parnate®. You should not use this medicine if you have heart disease, high blood pressure, diabetes, or an overactive thyroid. You should not use this medicine if you have a certain type of brain tumor, head injury, or a medical condition that causes increased pressure in your head (such as hydrocephalus). You should not use this medicine if you have trouble breathing.

How to Use This Medicine:
Tablet

• Your doctor will tell you how much medicine to use. Do not use more than directed.
• Drink plenty of liquids to help avoid constipation.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are using indomethacin (Indocin®) or methyldopa (Aldomet®). Tell your doctor if you are using a beta-blocker medicine such as atenolol, metoprolol (Toprol®), or propranolol (Inderal®). Beta-blocker medicines are often used to treat migraines, heart problems, or high blood pressure.
• Tell your doctor if you use anything else that makes you sleepy. Some examples are allergy medicine, narcotic pain medicine, and alcohol.
• While taking this medicine, do not also use other medicines that contain acetaminophen (Tylenol®). You may be getting more than a safe amount of this medicine.
• Do not drink alcohol while you are using this medicine. Tell your doctor if you drink alcohol on a regular basis.

Warnings While Using This Medicine:

• Make sure your doctor knows if you are pregnant or breast feeding or if you have a history of asthma or serious lung disease, such as emphysema (COPD). Make sure your doctor knows if you have a history of mental or emotional problems, or if you have had a problem with misusing drugs in the past.
• This medicine can be habit-forming. Do not use more than your prescribed dose. Call your doctor if you think your medicine is not working.
• Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine may interact with certain drugs given during a procedure or surgery, such as anesthesia (sleeping or relaxing medicine), or pain medicine.
• This medicine may hide the warning signs of certain serious medical conditions. Do not use this medicine if you are having abdominal (belly) pain, or have had a recent head injury, unless your doctor says it is okay.
• This medicine may make you dizzy or drowsy. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert.
• This medicine may cause constipation, especially with long-term use. Ask your doctor if you should use a laxative to prevent and treat constipation.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Extreme weakness.
• Confusion, hallucinations (seeing things that are not there), or fainting.
• New or worsening fever.
• Shallow breathing.
• Sudden or severe headache.
• Tremors (shaking).
• Trouble urinating, or feeling like you have a full bladder even after you urinate.

If you notice these less serious side effects, talk with your doctor:

• Anxiety or other mood changes that are bothersome to you.
• Blurred vision.
• Nausea and vomiting.

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088