Zoloft is an antidepressant in a group of drugs called selective serotonin reuptake inhibitors (SSRIs). Zoloft affects chemicals in the brain that may become unbalanced and cause depression, panic, anxiety, or obsessive-compulsive symptoms.

Zoloft is used to treat depression, obsessive-compulsive disorder, panic disorder, anxiety disorders, post-traumatic stress disorder (PTSD), and premenstrual dysphoric disorder (PMDD).

Zoloft may also be used for purposes other than those listed in this medication guide.

Important information about Zoloft (Sertraline)

Do not take Zoloft together with pimozide (Orap), or a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate). You must wait at least 14 days after stopping an MAOI before you can take Zoloft. After you stop taking Zoloft, you must wait at least 14 days before you start taking an MAOI.

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Zoloft is FDA-approved for children with obsessive-compulsive disorder (OCD). It is not approved for treating depression in children. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself. SSRI antidepressants may cause serious or life-threatening lung problems in newborn babies whose mothers take the medication during pregnancy. However, you may have a relapse of depression if you stop taking your antidepressant during pregnancy. If you are planning a pregnancy, or if you become pregnant while taking Zoloft, do not stop taking the medication without first talking to your doctor.

Before taking Zoloft (Sertraline)

Do not use Zoloft if you are using pimozide (Orap), or an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), rasagiline (Azilect), or selegiline (Eldepryl, Emsam). Serious and sometimes fatal reactions can occur when these medicines are taken with Zoloft. You must wait at least 14 days after stopping an MAO inhibitor before you can take sertraline. After you stop taking Zoloft, you must wait at least 14 days before you start taking an MAOI.

Before taking Zoloft, tell your doctor if you have:

• liver or kidney disease;
• seizures or epilepsy;
• bipolar disorder (manic depression); or
• a history of drug abuse or suicidal thoughts.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take Zoloft.

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening symptoms of depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment with Zoloft.

FDA pregnancy category C. SSRI antidepressants may cause serious or life-threatening lung problems in newborn babies whose mothers take the medication during pregnancy. However, you may have a relapse of depression if you stop taking your antidepressant during pregnancy. If you are planning a pregnancy, or if you become pregnant while taking Zoloft, do not stop taking the medication without first talking to your doctor. It is not known whether sertraline passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Do not give this medicine to anyone younger than 18 years old without the advice of a doctor. Zoloft is FDA-approved for children with obsessive-compulsive disorder (OCD). It is not approved for treating depression in children.

How should I take Zoloft (Sertraline)?

Take Zoloft exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Your doctor may occasionally change your dose to make sure you get the best results from the medication.

Take the Zoloft tablet with water.

Zoloft may be taken with or without food.

Try to take the medicine at the same time each day. Follow the directions on your prescription label.

The oral liquid form of this medicine must be diluted before you take it. To be sure you get the correct dose, measure the liquid with medicine dropper provided, not with a regular table spoon. Mix the dose with 4 ounces (one-half cup) of water, ginger ale, lemon/lime soda, lemonade, or orange juice. Do not use any other liquids to dilute the medicine. Stir this mixture and drink all of it right away. To make sure you get the entire dose, add a little more water to the same glass, swirl gently and drink right away.

It may take 4 weeks or longer before you start feeling better. Do not stop using Zoloft without first talking to your doctor. You may have unpleasant side effects if you stop taking this medication suddenly. Store Zoloft at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and take the next one as directed. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have taken too much of this medication. Symptoms of a Zoloft overdose may include dizziness, drowsiness, nausea, vomiting, rapid heartbeat, agitation, tremor, confusion, seizures, and coma.

Zoloft (Sertraline) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have any of these serious side effects:

• very stiff (rigid) muscles, high fever, sweating, fast or uneven heartbeats, tremors, overactive reflexes;
• nausea, vomiting, diarrhea, loss of appetite, feeling unsteady, loss of coordination; or
• headache, trouble concentrating, memory problems, weakness, confusion, hallucinations, fainting, seizure, shallow breathing or breathing that stops.

Less serious Zoloft side effects may include:

• drowsiness, dizziness, tired feeling;
• mild nausea, stomach pain, upset stomach, constipation;
• dry mouth;
• changes in appetite or weight;
• sleep problems (insomnia); or
• decreased sex drive, impotence, or difficulty having an orgasm.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Zoloft (Sertraline)?

Talk to your doctor before taking any medicine for pain, arthritis, fever, or swelling. This includes aspirin and NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), diclofenac (Voltaren), indomethacin, piroxicam (Feldene), nabumetone (Relafen), etodolac (Lodine), and others. Taking any of these drugs with Zoloft may cause you to bruise or bleed easily.

Before taking Zoloft, tell your doctor if you are using any of the following medicines:

• tramadol (Ultram, Ultram ER, Ultracet);
• digitoxin (Crystodigin);
• phenytoin (Dilantin), valproate (Depacon, Depakene);
• lithium (Lithobid, Eskalith);
• a blood thinner such as warfarin (Coumadin);
• any other antidepressant such as amitriptyline (Elavil), citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), imipramine (Tofranil), nortriptyline (Pamelor), or paroxetine (Paxil);
• almotriptan (Axert), frovatriptan (Frova), sumatriptan (Imitrex), naratriptan (Amerge), rizatriptan (Maxalt), or zolmitriptan (Zomig); or
• heart rhythm medication such as flecainide (Tambocor), propafenone (Rhythmol), and others.

This list is not complete and there may be other drugs that can interact with Zoloft. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

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Clozapine is an antipsychotic medication. It works by changing the actions of chemicals in the brain.

Clozapine is used to treat severe schizophrenia symptoms in people who have not responded to other medications. Clozapine is also used to help reduce the risk of suicidal behavior in people with schizophrenia or similar disorders.

Clozapine may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about Clozaril (Clozapine)?

Clozapine is not for use in psychotic conditions related to dementia. Clozapine may cause heart failure, sudden death, or pneumonia in older adults with dementia-related conditions. You should not take clozapine if you have uncontrolled epilepsy, paralytic ileus or intestinal blockage, an infection caused by clozapine, or if you are also using drugs that weaken your immune system (such as cancer medicine or steroids).

While you are taking clozapine, your blood may need to be tested every week for the first 6 months of treatment. Do not miss any scheduled blood tests.

Do not stop taking clozapine or change your dose without first talking to your doctor.

Call your doctor if you have shortness of breath, swelling in your hands or feet, fever, sore throat, sudden numbness or weakness, sudden vision or speech problems, chest pain, cough, wheezing, pain or swelling in one or both legs, seizure, or jaundice (yellowing of your skin or eyes).

There are many other medicines that can interact with clozapine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.

What should I discuss with my healthcare provider before taking  Clozaril (Clozapine)?

Clozapine is not for use in psychotic conditions related to dementia. Clozapine may cause heart failure, sudden death, or pneumonia in older adults with dementia-related conditions. You should not take this medication if you are allergic to clozapine, or if you have:

• untreated or uncontrolled epilepsy;
• paralytic ileus or intestinal blockage;
• a history of infection while taking clozapine; or
• if you are also using drugs that weaken your immune system (such as cancer medicine or steroids).

If you have certain conditions, you may need a dose adjustment or special tests to safely use this medication. Before taking clozapine, tell your doctor if you have:

• heart disease, heart rhythm disorder, high blood pressure, or a history of heart attack;
• liver or kidney disease;
• lung disease;
• diabetes;
• a history of bone marrow or blood cell disorders;
• glaucoma; or
• an enlarged prostate or urination problems.

Clozapine may raise your blood sugar, causing symptoms such as increased thirst, loss of appetite, increased urination, drowsiness, nausea, or fruity breath odor. Call your doctor right away if you have any of these symptoms.

FDA pregnancy category B: This medication is not expected to be harmful to an unborn baby. Do not use clozapine without telling your doctor if you are pregnant or plan to become pregnant during treatment. Clozapine can pass into breast milk and may harm a nursing baby. You should not use this medication if you are breast-feeding a baby.

Clozapine orally-disintegrating tablets contain phenylalanine. Talk to your doctor before using this form of clozapine if you have phenylketonuria (PKU).

How should I take Clozaril (Clozapine)?

Take clozapine exactly as it was prescribed for you. Do not take it in larger doses or for longer than recommended by your doctor. Follow the directions on your prescription label.

Clozapine can be taken with or without food.

Take the regular oral tablet (Clozaril) with a full glass of water.

The orally-disintegrating tablet (FazaClo) can be taken without water. Gently peel back the foil from the blister pack and drop the tablet onto your dry hand. Do not push tablet through the foil. Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing. Swallow several times as the tablet dissolves. If desired, you may drink liquid to help swallow the dissolved tablet.

If your doctor has prescribed one-half of an orally-disintegrating tablet, you will need to break the tablet in half. Throw the other half away. Do not store it for later use.

While you are taking clozapine, your blood may need to be tested every week for the first 6 months of treatment. Do not miss any scheduled blood tests. After 6 months, blood tests may be needed less often.

If you stop taking clozapine for more than 2 days in a row, call your doctor before you start taking it again. You may need a lower dose. Do not stop taking clozapine or change your dose without first talking to your doctor. If you need to have any type of surgery, tell the surgeon ahead of time that you are using clozapine. Store clozapine at room temperature away from moisture and heat. Keep each FazaClo tablet in the unopened blister pack until you are ready to take the medicine.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include confusion, fast heart rate, drowsiness, drooling, weak or shallow breathing, feeling like you might pass out, and seizure (convulsions).

Clozaril (Clozapine) side effects

Stop using clozapine and get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:

• feeling short of breath, even at night or with mild exertion;
• swelling in your hands or feet;
• fever, weakness, sore throat, stiff muscles, confusion, sweating, fast or uneven heartbeats;
• sudden numbness or weakness, especially on one side of the body;
• sudden headache, confusion, problems with vision, speech, or balance;
• chest pain, sudden cough, wheezing, rapid breathing, fast heart rate, pain or swelling in one or both legs;
• white patches or sores inside your mouth or on your lips;
• nausea, vomiting, loss of appetite, and jaundice (yellowing of your skin or eyes); or
• seizure (black-out or convulsions).

Less serious side effects may include:

• constipation;
• drooling, especially at night;
• increased sweating;
• drowsiness, dizziness, spinning sensation;
• sleep problems or nightmares; or
• weight gain.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

What other drugs will affect Clozaril (Clozapine)?

Before taking clozapine, tell your doctor if you are using any of the following drugs:

• cimetidine (Tagamet);
• citalopram (Celexa);
• lithium (Eskalith, Lithobid);
• rifampin (Rifadin, Rimactane);
• blood pressure medications;
• heart rhythm medications such as propafenone (Rythmol) or flecaininde (Tambocor);
• seizure medicine such as phenytoin (Dilantin) or carbamazepine (Carbatrol, Tegretol);
• antibiotics such as ciprofloxacin (Cipro) or erythromycin (E-Mycin, E.E.S, Ery-Tab);
• atropine (Donnatal, and others), belladonna, clidinium (Quarzan), dicyclomine (Bentyl), scopolamine (Transderm-Scop); or
• diazepam (Valium) or similar medicines such as alprazolam (Xanax), clonazepam (Klonopin), lorazepam (Ativan), midazolam (Versed), temazepam (Restoril), and others.

This list is not complete and there may be other drugs that can interact with clozapine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

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Stress Gum is an innovative gum that provides you with most effective way to calm stressed nerves and promote a sense of well-being naturally. Being superior to a pill, Stress Gum is absorbed into the bloodstream immediately to give the powerful results you want.

Stress Gum also helps fight tooth decay and cleans teeth after meals, provides a no-calorie snack, improves concentration, relaxes and eases tension, freshens breath, and improves digestion. Here’s an additional suggestion. Chew Stress Gum the next time you’re on a plane to counteract the effect of air pressure changes on your ears.

Additional Benefits:

• Helps fight tooth decay and cleans teeth after meals;
• Provides a no-calorie snack;
• Improves concentration;
• Relaxes and eases tension;
• Freshens breath;
• Improves digestion.

How Taken

Simply chew two (2) to six (6) pieces of gum daily. Many men choose to accelerate their results by chewing up to six (6) perfectly safe pieces of gum daily. However, we do not recommend exceeding six (6) pieces of gum daily.

A one (1) month supply consists of five (5) packages of gum (60 pieces). A two months supply consists of ten (10) packages of gum (120 pieces). A four (4) months supply consists of twenty (20) packages of gum (240 pieces). A six (6) months supply consists of thirty (30) packages of gum (360 pieces). Each individual package of Stress Gum contains 12 pieces of gum.

Drug Class and Mechanism

Each piece of gum contains a revolutionary sustained release system that orally delivers the 120-mg proprietary blend of active ingredients that are absorbed directly into the bloodstream. This delivery system relies on micro-sized beads that are released by chewing the gum and are immediately absorbed into the tissue of the lining in the mouth through the capillaries that lie close to the surface. This process allows the supplement to be absorbed within seconds and bypasses the solubility and absorption problems that accompany traditional nutritional supplements.

Ingredients:

• CALCIUM CARBONATE is needed to form strong bones and teeth, healthy gums, maintain regular heart beat and nerve impulse transmission.
• ASHWAGANDHA is touted for promoting calmness and a sense of well-being.
• PASSION FLOWER relieves tension, anxiety, and insomnia, due to its calming effect on the central nervous system. Studies conducted since the 1930’s indicate that Passion Flower is a safe non-addictive herb that promotes relaxation. It is also mildly effective in treating nervous stomachs and indigestion.
• JUJUBE FRUITS are considered to have stress alleviating properties. Jujube fruit is used to calm nerves and anxiety. It is a popular stress buster in many parts of the world and also known for its rejuvenating properties. The fruit is also known to purify blood and de-toxify the system. It is considered good for clearing up skin and for preventing heart problems.

Missed Dose

If you miss a dose of Stress Gum, use it as soon as you remember.

Storage

Store Stress Gum between 59 and 77 degrees F (15 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Stress Gum out of the reach of children and away from pets.

Warnings/Precautions

We have received no reports of our product interacting negatively prescribed medications. It is generally recommended, however, that those who have concerns about such interaction consult a physician before using any type of supplement, vitamin, or medication.

Possible Side Effects

Over four safe, carefully chosen herbs are used to manufacture Stress Gum. Each individual herb is safe and has been in common use for centuries. All of the natural ingredients in are listed on the Food and Drug Administration GRAS list of safe foods, making it the best product on the market to relieve menopausal symptoms naturally. Of course, as with any dietary supplement, those with special medical conditions are encouraged to consult their doctor or healthcare professional before use.

More Information

The U.S. Armed Forces have supplied soldiers with chewing gum since World War I because it helps both to improve the soldiers’ concentration and to relieve stress. Recent studies show chewing gum can also improve one’s mood.

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Fluvoxamine is an antidepressant in a group of drugs called selective serotonin reuptake inhibitors (SSRIs). Fluvoxamine affects chemicals in the brain that may become unbalanced and cause obsessive-compulsive symptoms.

Fluvoxamine is used to treat social anxiety disorder (social phobia), or obsessive-compulsive disorders involving recurring thoughts or actions.

Fluvoxamine may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about Luvox (Fluvoxamine)?

Do not take this medication if you are allergic to fluvoxamine, or if you are also taking alosetron (Lotronex), tizanidine (Zanaflex), thioridazine (Mellaril), pimozide (Orap), or an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), rasagiline (Azilect), or selegiline (Eldepryl, Emsam). Some of these medications can cause serious or life-threatening drug interactions when taken within 14 days before or after taking fluvoxamine.

You may have thoughts about suicide when you first start taking an this medication, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), depressed, or have thoughts about suicide or hurting yourself. There are many other medicines that can cause serious medical problems if you take them together with fluvoxamine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.

What should I discuss with my healthcare provider before taking Luvox (Fluvoxamine)?

You should not take this medication if you are allergic to fluvoxamine, or if you are also taking:

• alosetron (Lotronex);
• tizanidine (Zanaflex);
• thioridazine (Mellaril);
• pimozide (Orap); or
• an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), rasagiline (Azilect), or selegiline (Eldepryl, Emsam).

Some of these medications can cause serious or life-threatening drug interactions when taken together with fluvoxamine. You must wait at least 14 days after stopping an MAO inhibitor before you can take fluvoxamine. After you stop taking fluvoxamine, you must wait at least 14 days before you can start taking an MAOI.

Before taking fluvoxamine, tell your doctor if you have:

• liver disease;
• seizures or epilepsy;
• bipolar disorder (manic depression); or
• a history of drug abuse or suicidal thoughts.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take fluvoxamine.

You may have thoughts about suicide when you first start taking fluvoxamine, especially if you are younger than 24 years old. Tell your doctor if you have symptoms of depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

FDA pregnancy category C. This medication may cause serious or life-threatening lung problems in newborn babies whose mothers take the medication during pregnancy. However, you may have a relapse of symptoms if you stop taking fluvoxamine during pregnancy. If you are planning a pregnancy, or if you become pregnant while taking fluvoxamine, do not stop taking the medication without first talking to your doctor. Fluvoxamine can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Do not give fluvoxamine to anyone younger than 18 years old without the advice of a doctor.

How should I take Luvox (Fluvoxamine)?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Do not crush, chew, or open an extended-release capsule. Swallow the pill whole. Breaking or opening the pill may cause too much of the drug to be released at one time.

You may take fluvoxamine with or without food.

Do not stop using fluvoxamine without first talking to your doctor. You may have unpleasant side effects if you stop taking this medication suddenly. Store fluvoxamine at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and take the next one as directed. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have taken too much of this medication. Overdose symptoms may include blurred vision, lack of coordination, extreme drowsiness, nausea and vomiting, fast heart rate, trouble breathing, fainting, and coma.

Luvox (Fluvoxamine) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have a serious side effect such as:

• seizure (convulsions);
• unusual thoughts or behavior;
• anxiety, restlessness, memory problems, trouble concentrating, hallucinations, feeling like you might pass out;
• high fever, chills or goose bumps, loss of coordination, overactive reflexes, stiff muscles; or
• confusion, sweating, fast or uneven heartbeats, and rapid breathing.

Less serious side effects may include:

• loss of appetite, weight loss;
• dry mouth, mild nausea or upset stomach, diarrhea, constipation;
• sleep problems (insomnia);
• dizziness, drowsiness;
• decreased sex drive, impotence, trouble having an orgasm; or
• unusual dreams.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

What other drugs will affect Luvox (Fluvoxamine)?

Talk to your doctor before taking any medicine for pain, arthritis, fever, or swelling. This includes aspirin and NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), diclofenac (Voltaren), indomethacin, piroxicam (Feldene), nabumetone (Relafen), etodolac (Lodine), and others. Taking any of these drugs with fluvoxamine may cause you to bruise or bleed easily.

Many drugs can interact with fluvoxamine. Below is just a partial list. Tell your doctor if you are using:

• carbamazepine (Carbatrol, Tegretol);
• clozapine (Clozaril, FazaClo);
• a diuretic (water pill);
• linezolid (Zyvox);
• lithium (Lithobid, Eskalith);
• methadone (Dolophine, Methadose);
• mexiletine (Mexitil);
• omeprazole (Prilosec);
• phenytoin (Dilantin);
• propranolol (Inderal, Inderal LA);
• quinidine (Quinaglute, Quinidex, Quin-Release);
• ramelteon (Rozerem);
• St. John’s wort;
• tacrine (Cognex);
• tramadol (Ultram);
• tryptophan (also called L-tryptophan);
• theophylline (Aerolate, Bronkodyl, Slo-Bid, Theo-Dur);
• a blood thinner such as warfarin (Coumadin);
• a sedative such as diazepam (Valium), alprazolam (Xanax), midazolam (Versed), or triazolam (Halcion);
• almotriptan (Axert), frovatriptan (Frova), sumatriptan (Imitrex), naratriptan (Amerge), rizatriptan (Maxalt), or zolmitriptan (Zomig);
• medicine to treat psychiatric disorders, such as chlorpromazine (Thorazine), haloperidol (Haldol), perphenazine (Trilafon), and others; or
• an antidepressant such as amitriptyline (Elavil), clomipramine (Anafranil), imipramine (Tofranil), and others.

This list is not complete and there are many other medicines that can cause serious medical problems if you take them together with fluvoxamine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.

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Paroxetine is an antidepressant in a group of drugs called selective serotonin reuptake inhibitors (SSRIs). Paroxetine affects chemicals in the brain that may become unbalanced.

Paroxetine is used to treat depression, obsessive-compulsive disorder, anxiety disorders, post-traumatic stress disorder (PTSD), and premenstrual dysphoric disorder (PMDD).

Paroxetine may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about Paroxetine?

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself. Paroxetine may cause heart defects or serious, life-threatening lung problems in newborn babies whose mothers take the medication during pregnancy. However, you may have a relapse of depression if you stop taking your antidepressant during pregnancy. If you are planning a pregnancy, or if you become pregnant while taking paroxetine, do not stop taking the medication without first talking to your doctor. Do not take paroxetine together with pimozide (Orap), thioridazine (Mellaril), or a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate).

What should I discuss with my healthcare provider before taking Paroxetine?

Do not use paroxetine if you are using pimozide (Orap), thioridazine (Mellaril), or an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), rasagiline (Azilect), or selegiline (Eldepryl, Emsam). Serious and sometimes fatal reactions can occur when these medicines are taken with paroxetine. You must wait at least 14 days after stopping an MAO inhibitor before you can take paroxetine. After you stop taking paroxetine, you must wait at least 14 days before you start taking an MAOI.

Before taking paroxetine, tell your doctor if you are allergic to any drugs, or if you have:

• liver or kidney disease;
• a bleeding or blood clotting disorder;
• seizures or epilepsy; or
• bipolar disorder (manic depression), or a history of drug abuse or suicidal thoughts.

If you have any of these conditions, you may need a dose adjustment or special tests to safely use this medication.

You may have thoughts about suicide while taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

FDA pregnancy category D. Paroxetine may cause heart defects or serious, life-threatening lung problems in newborn babies whose mothers take the medication during pregnancy. However, you may have a relapse of depression if you stop taking your antidepressant during pregnancy. If you are planning a pregnancy, or if you become pregnant while taking paroxetine, do not stop taking the medication without first talking to your doctor. Paroxetine can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take Paroxetine?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Your doctor may occasionally change your dose to make sure you get the best results from the medication.

Try to take the medicine at the same time each day. Follow the directions on your prescription label.

Do not crush, chew, or break a controlled-release tablet. Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking the pill would cause too much of the drug to be released at one time. Shake the liquid form of paroxetine well just before you measure a dose. To be sure you get the correct dose, measure the liquid with a marked measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one. It may take up to 4 weeks of using this medicine before your symptoms improve. For best results, keep using the medication as directed. Talk with your doctor if your symptoms do not improve after 4 weeks of treatment.

You may have withdrawal symptoms (such as agitation, dizziness, numbness or tingling, ringing in your ears, confusion, or behavior changes) after you stop taking paroxetine. Do not stop taking this medication suddenly without first talking to your doctor.

Store paroxetine at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and take the next one as directed. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have taken too much of this medication. Overdose symptoms may include nausea, vomiting, tremor, sweating, decreased urination, blurred vision, rapid heartbeat, confusion, aggression, seizures, and coma.

Paroxetine side effects

Get emergency medical help if you have any of these signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Contact your doctor promptly if you have any of the following side effects, especially if they are new symptoms or if they get worse: mood changes, anxiety, panic attacks, trouble sleeping, irritability, agitation, aggressiveness, severe restlessness, mania (mental and/or physical hyperactivity), thoughts of suicide or hurting yourself.

Call your doctor at once if you have any of these serious side effects:

• easy bruising or bleeding (such as a nosebleed);
• very stiff (rigid) muscles, high fever, sweating, fast or uneven heartbeats, tremors, overactive reflexes;
• nausea, vomiting, diarrhea, loss of appetite, feeling unsteady, loss of coordination; or
• headache, trouble concentrating, memory problems, weakness, confusion, hallucinations, fainting, seizure, shallow breathing or breathing that stops.

Less serious side effects may include:

• feeling nervous;
• drowsiness, dizziness;
• sleep problems (insomnia);
• mild nausea, constipation;
• weight changes;
• decreased sex drive, impotence, or difficulty having an orgasm; or
• dry mouth, yawning, or ringing in your ears.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Paroxetine Dosing Information

Usual Adult Dose for Depression:

Immediate release tablets and suspension:
Initial dose: 20 mg orally once a day with or without food, usually in the morning.
Maintenance dose: 20 to 50 mg orally once a day with or without food, usually in the morning.
Dosage change: Dose may be increased in 10 mg per day increments at intervals of at least one week.

Extended release tablets:
Initial dose:
Paroxetine- naive patients: 25 mg orally once a day with or without food, usually in the morning.
Conversion: 30 mg immediate release paroxetine corresponds to 37.5 mg extended release tablets.
Maintenance dose: The initial dose may be increased to a maximum of 62.5 mg per day.
Dosage change: Dose may be increased in 12.5 mg per day increments at intervals of at least one week.
Caution: Extended release tablets should be swallowed whole and not chewed or crushed.

Usual Adult Dose for Anxiety:

Immediate release tablets and suspension:
Initial dose: 20 mg orally once a day with or without food, usually in the morning.
Maintenance dose: Doses up to 60 mg orally once a day with or without food, usually in the morning, can be used.
Dosage change: Dose may be increased in 10 mg per day increments at intervals of at least one week.

Extended release tablets:
Initial dose: 12.5 mg orally once a day with or without food, usually in the morning.
Maintenance dose: The initial dose may be increased in 12.5 mg increments weekly, to a maximum of 37.5 mg per day.
Dosage change: May occur at intervals of at least one week.
Caution: Extended release tablets should be swallowed whole and not chewed or crushed.

Usual Adult Dose for Panic Disorder:

Immediate release tablets and suspension:
Initial dose: 10 mg orally once a day with or without food, usually in the morning.
Maintenance dose: 40 mg orally once daily with or without food, usually in the morning. Doses up to 60 mg orally once a day in the morning can be used.
Dosage change: May occur in 10 mg per day increments at intervals of at least one week.

Extended release tablets:
Initial dose: Paroxetine- naive patients: 12.5 mg orally once a day with or without food, usually in the morning.
Maintenance dose: The initial dose may be increased in 12.5 mg per day increments at intervals of at least one week, to a maximum of 75 mg per day.
Caution: Extended release tablets should be swallowed whole and not chewed or crushed.

Usual Adult Dose for Premenstrual Dysphoric Disorder:

Extended release tablets:
Initial: 12.5 mg orally once a day with or without food, usually in the morning continuously, or alternatively, 12.5 mg orally once a day with or without food, usually in the morning during the luteal phase of the menstrual cycle (the 14 days prior to the anticipated start of menses).
Maintenance: Doses up to 25 mg once a day with or without food, usually in the morning, have been shown to be effective in clinical trials. Effectiveness for a period exceeding 3 menstrual cycles has not been evaluated in controlled trials. However, it is reasonable to consider continuation in a responding patient.
Dosage change: May occur at intervals of at least one week.
Caution: Extended release tablets should be swallowed whole and not chewed or crushed.

Usual Adult Dose for Obsessive Compulsive Disorder:

Immediate release tablets and suspension:
Initial dose: 20 mg orally once a day with or without food, usually in the morning.
Maintenance dose: 40 mg orally once a day with or without food, usually in the morning. Doses up to 60 mg orally once a day in the morning can be used.
Dosage change: Dose may be increased in 10 mg per day increments at intervals of at least one week.

Usual Adult Dose for Post Traumatic Stress Disorder:

Immediate release tablets and suspension:
Initial dose: 20 mg orally once a day with or without food, usually in the morning.
Maintenance dose: 20 to 50 mg orally once a day with or without food, usually in the morning.
Dosage change: Dose may be increased in 10 mg per day increments at intervals of at least one week.

Usual Geriatric Dose for not applicable:

Immediate release tablets and suspension:
Initial dose: 10 mg orally once a day with or without food, usually in the morning.
Maintenance dose: 10 to 40 mg per day.
Dosage change: Dose may be increased in 10 mg per day increments at intervals of at least one week.

Extended release tablets:
Initial dose: Paroxetine- naive patients: 12.5 mg orally once a day with or without food, usually in the morning.
Maintenance dose: Maximum of 50 mg per day.
Dosage change: Dose may be increased in 12.5 mg per day increments at intervals of at least one week.
Caution: Extended release tablets should be swallowed whole and not chewed or crushed.

What other drugs will affect Paroxetine?

Talk to your doctor before taking any medicine for pain, arthritis, fever, or swelling. This includes aspirin and NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), diclofenac (Voltaren), indomethacin, piroxicam (Feldene), nabumetone (Relafen), etodolac (Lodine), and others. Taking any of these drugs with paroxetine may cause you to bruise or bleed easily.

Many drugs can interact with paroxetine. Below is just a partial list. Tell your doctor if you are using:

• a blood thinner such as warfarin (Coumadin);
• cimetidine (Tagamet);
• fosamprenavir (Lexiva);
• linezolid (Zyvox);
• ritonavir (Norvir);
• St. John’s wort;
• tamoxifen (Nolvadex, Soltamox);
• theophylline (Elixophyllin, Theo-24, Uniphyl);
• tramadol (Ultram);
• tryptophan (also called L-tryptophan);
• heart medication such as digoxin (digitalis, Lanoxin), flecainide (Tambocor), quinidine (QuinaGlute, Quinidex, Quin-Release), risperidone (Risperdal), or propafenone (Rhythmol);
• any other antidepressant such as amitriptyline (Elavil), citalopram (Celexa), desipramine (Norpramin), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), imipramine (Tofranil), nortriptyline (Pamelor), or sertraline (Zoloft);
• medicine to treat psychiatric disorders, such as chlorpromazine (Thorazine), fluphenazine (Permitil, Prolixin), haloperidol (Haldol), lithium (Lithobid, Eskalith), or perphenazine (Trilafon); or
• almotriptan (Axert), frovatriptan (Frova), sumatriptan (Imitrex), naratriptan (Amerge), rizatriptan (Maxalt), or zolmitriptan (Zomig).

This list is not complete and there may be other drugs that can interact with paroxetine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

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Citalopram is used for treating depression. It may also be used for other conditions as determined by your doctor.

How Taken

Use Citalopram as directed by your doctor.

Drug Class and Mechanism

Citalopram is a selective serotonin reuptake inhibitor (SSRI). It works by restoring the balance of serotonin, a natural substance in the brain, which helps to improve certain mood problems.

Missed Dose

If you miss a dose of Citalopram, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Storage

Store Citalopram at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Keep Citalopram out of the reach of children and away from pets.

Warnings/Precautions

Do not use Citalopram if:

• you are allergic to any ingredient in Citalopram;
• you are taking escitalopram;
• you are taking or have taken a monoamine oxidase inhibitor (MAOI) (e.g., phenelzine), selegiline, or St. John’s wort within the last 14 days;
• you are taking a fenfluramine derivative (e.g., dexfenfluramine), an H1 antagonist (e.g., astemizole, terfenadine), nefazodone, pimozide, or sibutramine.

Contact your doctor or health care provider right away if any of these apply to you.

Important:

• Citalopram may cause drowsiness or dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use Citalopram with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
• Do not drink alcohol while you are using Citalopram.
• Check with your doctor before you use medicines that may cause drowsiness (e.g., sleep aids, muscle relaxers) while you are using Citalopram; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
• One to 4 weeks may pass before your symptoms improve. Do not take more than the recommended dose, change your dose, or use Citalopram for longer than prescribed without checking with your doctor.
• Children, teenagers, and young adults who take Citalopram may be at increased risk for suicidal thoughts or actions. Watch all patients who take Citalopram closely. Contact the doctor at once if new, worsened, or sudden symptoms such as depressed mood; anxious, restless, or irritable behavior; panic attacks; or any unusual change in mood or behavior occur. Contact the doctor right away if any signs of suicidal thoughts or actions occur.
• Citalopram and a medicine called escitalopram have the same active ingredient. Do not take Citalopram if you are also taking escitalopram.
• Citalopram may rarely cause a prolonged, painful erection. This could happen even when you are not having sex. If this is not treated right away, it could lead to permanent sexual problems such as impotence. Contact your doctor right away if this happens.

Possible Side Effects

Check with your doctor if any of these most common side effects persist or become bothersome:

• Decreased sexual desire or ability; diarrhea; dizziness; drowsiness; dry mouth; increased sweating; lightheadedness when you stand or sit up; loss of appetite; nausea; stuffy nose; tiredness.

Seek medical attention right away if any of these severe side effects occur:

• Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); absent menstrual period; bizarre behavior; black or bloody stools; chest pain; confusion; decreased concentration; fast or irregular heartbeat; hallucinations; memory loss; new or worsening agitation, panic attacks, aggressiveness, impulsiveness, irritability, hostility, exaggerated feeling of well-being, restlessness, or inability to sit still; persistent, painful erection; red, swollen, blistered, or peeling skin; seizures; severe or persistent anxiety or trouble sleeping; stomach pain; suicidal thoughts or attempts; tremor; unusual bruising or bleeding; unusual or severe mental or mood changes; vision changes; worsening of depression.

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Tofranil (Imipramine) is in a group of drugs called tricyclic antidepressants. Imipramine affects chemicals in the brain that may become unbalanced.

Tofranil (Imipramine) is used to treat symptoms of depression.

Tofranil (Imipramine) may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about Tofranil (imipramine)?

Do not use imipramine if you have recently had a heart attack, or if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days.

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

What should I discuss with my healthcare provider before taking Tofranil (imipramine)?

Do not use this medication if you are allergic to imipramine, or if you have recently had a heart attack. Do not use imipramine if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take imipramine before the MAO inhibitor has cleared from your body.

Before taking imipramine, tell your doctor if you are allergic to any drugs, or if you have:

• heart disease;
• a history of heart attack, stroke, or seizures;
• bipolar disorder (manic-depression);
• kidney or liver disease;
• overactive thyroid;
• diabetes (imipramine may raise or lower blood sugar);
• adrenal gland tumor (pheochromocytoma);
• glaucoma; or
• problems with urination.

If you have any of these conditions, you may not be able to use imipramine, or you may need a dosage adjustment or special tests during treatment.

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening symptoms of depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Imipramine can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Do not give this medication to anyone younger than 18 years old without the advice of a doctor.

How should I take Tofranil (imipramine)?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Your doctor may occasionally change your dose to make sure you get the best results from this medication. Follow the directions on your prescription label.

If you need to have any type of surgery, tell the surgeon ahead of time that you are taking imipramine. You may need to stop using the medicine for a short time.

Do not stop using imipramine without first talking to your doctor. You may need to use less and less before you stop the medication completely. Stopping this medication suddenly could cause you to have unpleasant side effects. It may take up to 3 weeks of using this medicine before your symptoms improve. For best results, keep using the medication as directed. Talk with your doctor if your symptoms do not improve after 3 weeks of treatment. Store imipramine at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. An overdose of imipramine can be fatal.

Symptoms of an imipramine overdose may include uneven heartbeats, extreme drowsiness, agitation, vomiting, blurred vision, sweating, muscle stiffness, swelling, shortness of breath, blue lips or fingernails, feeling light-headed, fainting, seizure (convulsions), or coma.

Tofranil (imipramine) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have any of these serious side effects:

• fast, pounding, or uneven heart rate;
• chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;
• sudden numbness or weakness, especially on one side of the body;
• sudden headache, confusion, problems with vision, speech, or balance;
• feeling short of breath, even with mild exertion;
• swelling, rapid weight gain;
• confusion, hallucinations, or seizure (convulsions);
• easy bruising or bleeding, unusual weakness;
• restless muscle movements in your eyes, tongue, jaw, or neck;
• urinating more or less than usual;
• extreme thirst with headache, nausea, vomiting, and weakness;
• skin rash, bruising, severe tingling, numbness, pain, or muscle weakness.

Less serious side effects may be more likely to occur, such as:

• nausea, vomiting, stomach pain, loss of appetite;
• constipation or diarrhea;
• dry mouth, unpleasant taste;
• weight changes;
• weakness, lack of coordination;
• feeling dizzy, drowsy, or tired;
• nightmares;
• blurred vision, headache, ringing in your ears;
• breast swelling (in men or women); or
• decreased sex drive, impotence, or difficulty having an orgasm.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect Tofranil (imipramine)?

Before taking imipramine, tell your doctor if you have used an “SSRI” antidepressant in the past 5 weeks, such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), or sertraline (Zoloft).

Before taking imipramine, tell your doctor if you are currently using any of the following drugs:

• cimetidine (Tagamet);
• clonidine (Catapres);
• guanethidine (Ismelin);
• methylphenidate (Concerta, Ritalin, Daytrana); or
• heart rhythm medications such as flecainide (Tambocor), propafenone (Rhythmol), or quinidine (Cardioquin, Quinidex, Quinaglute).

If you are using any of these drugs, you may not be able to use imipramine, or you may need dosage adjustments or special tests during treatment.

There are many other medicines that can interact with imipramine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.

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Celexa is an antidepressant in a group of drugs called selective serotonin reuptake inhibitors (SSRIs). It works by restoring the balance of serotonin, a natural occuring substance found in the brain, which helps to improve certain mood problems.

Celexa is used to treat depression.

Celexa may also be used for purposes other than those listed in this medication guide.

Important information about Celexa (Citalopram)

Do not take Celexa together with a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate). You must wait at least 14 days after stopping an MAOI before you can take Celexa. After you stop taking Celexa, you must wait at least 14 days before you start taking an MAOI.

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment with Celexa.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself. Some antidepressants may cause serious or life-threatening lung problems in newborn babies whose mothers take the medication during pregnancy. However, you may have a relapse of depression if you stop taking your antidepressant during pregnancy. If you are planning a pregnancy, or if you become pregnant while taking Celexa, do not stop taking the medication without first talking to your doctor.

Before taking Celexa (Citalopram)

Do not use Celexa if you are using an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), rasagiline (Azilect), or selegiline (Eldepryl, Emsam). Serious and sometimes fatal reactions can occur when these medicines are taken with Celexa. You must wait at least 14 days after stopping an MAO inhibitor before you can take citalopram. After you stop taking Celexa, you must wait at least 14 days before you start taking an MAOI.

Before taking Celexa, tell your doctor if you are allergic to any drugs, or if you have:

• liver or kidney disease;
• seizures or epilepsy;
• bipolar disorder (manic depression); or
• a history of drug abuse or suicidal thoughts.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take Celexa.

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening symptoms of depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment with Celexa.

FDA pregnancy category C. SSRI antidepressants may cause serious or life-threatening lung problems in newborn babies whose mothers take the medication during pregnancy. However, you may have a relapse of depression if you stop taking your antidepressant during pregnancy. If you are planning a pregnancy, or if you become pregnant while taking Celexa, do not stop taking the medication without first talking to your doctor. Celexa can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Do not give this medication to anyone younger than 18 years old without the advice of a doctor.

How should I take Celexa (Citalopram)?

Take Celexa exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Your doctor may occasionally change your dose to make sure you get the best results from the medication.

Try to take the medicine at the same time each day. Follow the directions on your prescription label.

To be sure you get the correct dose of liquid Celexa, measure the liquid with a marked measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

It may take 4 weeks or longer before you start feeling better. Do not stop using Celexa without first talking to your doctor. You may have unpleasant side effects if you stop taking this medication suddenly. Store Celexa at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and take the next one as directed. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have taken too much of this medication. Symptoms of a Celexa overdose may include nausea, vomiting, tremor, sweating, rapid heartbeat, confusion, dizziness, seizures, and coma.

Celexa (Citalopram) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have any of these serious side effects:

• very stiff (rigid) muscles, high fever, sweating, fast or uneven heartbeats, tremors, overactive reflexes;
• nausea, vomiting, diarrhea, loss of appetite, feeling unsteady, loss of coordination; or
• headache, trouble concentrating, memory problems, weakness, confusion, hallucinations, fainting, seizure, shallow breathing or breathing that stops.

Less serious Celexa side effects may include:

• drowsiness;
• sleep problems (insomnia);
• mild nausea, gas, upset stomach;
• weight changes;
• urinating more than usual;
• decreased sex drive, impotence, or difficulty having an orgasm;
• dry or watery mouth, yawning; or
• cold symptoms such as stuffy nose, sneezing, sore throat.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Celexa (Citalopram)?

Talk to your doctor before taking any medicine for pain, arthritis, fever, or swelling. This includes aspirin and NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), diclofenac (Voltaren), indomethacin, piroxicam (Feldene), nabumetone (Relafen), etodolac (Lodine), and others. Taking any of these drugs with Celexa may cause you to bruise or bleed easily.

Before taking Celexa, tell your doctor if you are using any of the following medicines:

• carbamazepine (Tegretol);
• cimetidine (Tagamet);
• lithium (Lithobid, Eskalith);
• a blood thinner such as warfarin (Coumadin);
• any other antidepressants such as amitriptyline (Elavil), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), imipramine (Tofranil), nortriptyline (Pamelor), paroxetine (Paxil), or sertraline (Zoloft); or
• almotriptan (Axert), frovatriptan (Frova), sumatriptan (Imitrex), naratriptan (Amerge), rizatriptan (Maxalt), or zolmitriptan (Zomig).

This list is not complete and there may be other drugs that can interact with Celexa. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

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Olanzapine is an antipsychotic medication. It works by changing the actions of chemicals in the brain.

Olanzapine is used to treat the symptoms of psychotic conditions such as schizophrenia and bipolar disorder (manic depression).

Olanzapine may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about olanzapine?

Olanzapine is not for use in psychotic conditions related to dementia. Olanzapine may cause heart failure, sudden death, or pneumonia in older adults with dementia-related conditions.

Olanzapine may cause you to have high blood sugar (hyperglycemia). Symptoms include increased thirst, loss of appetite, increased urination, nausea, vomiting, drowsiness, dry skin, and dry mouth. If you are diabetic, check your blood sugar levels on a regular basis while you are taking olanzapine.

It may take up to 4 weeks of using this medicine before your symptoms improve. For best results, keep using the medication as directed. Talk with your doctor if your symptoms do not improve after 4 weeks of treatment. Olanzapine can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Avoid drinking alcohol, which can increase some of the side effects of olanzapine. Avoid becoming overheated or dehydrated. Drink plenty of fluids, especially in hot weather and during exercise. It is easier to become dangerously overheated and dehydrated while you are taking olanzapine.

What should I discuss with my healthcare provider before taking olanzapine?

Olanzapine is not for use in psychotic conditions related to dementia. Olanzapine may cause heart failure, sudden death, or pneumonia in older adults with dementia-related conditions.

If you have certain conditions, you may need a dose adjustment or special tests to safely use this medication. Before you take olanzapine, tell your doctor if you have:

• liver disease;
• kidney disease;
• heart disease, high blood pressure, heart rhythm problems;
• high cholesterol or triglycerides;
• a history of heart attack or stroke;
• a history of breast cancer;
• seizures or epilepsy;
• a personal or family history of diabetes;
• an enlarged prostate or difficulty urinating;
• glaucoma; or
• trouble swallowing.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Olanzapine can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

The olanzapine orally disintegrating tablet (Zyprexa Zydis) may contain phenylalanine. Talk to your doctor before using this form of olanzapine if you have phenylketonuria (PKU).

How should I take olanzapine?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Take this medicine with a full glass of water.

Olanzapine can be taken with or without food.

Olanzapine is usually taken once a day. Follow your doctor’s instructions.

To take olanzapine orally disintegrating tablets (Zyprexa Zydis):

• Keep the tablet in its blister pack until you are ready to take the medicine. Open the package and peel back the foil from the tablet blister. Do not push a tablet through the foil or you may damage the tablet.
• Using dry hands, remove the tablet and place it in your mouth. It will begin to dissolve right away.
• Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing.
• Swallow several times as the tablet dissolves. If desired, you may drink liquid to help swallow the dissolved tablet.

It may take up to 4 weeks of using this medicine before your symptoms improve. For best results, keep using the medication as directed. Talk with your doctor if your symptoms do not improve after 4 weeks of treatment.

Olanzapine may cause you to have high blood sugar (hyperglycemia). Symptoms include increased thirst, loss of appetite, increased urination, nausea, vomiting, drowsiness, dry skin, and dry mouth. If you are diabetic, check your blood sugar levels on a regular basis while you are taking olanzapine.

To be sure this medication is helping your condition, your doctor will need to check your progress on a regular basis. Do not miss any scheduled appointments.

Store olanzapine at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include drowsiness, agitation, aggression, slurred speech, confusion, increased heart rate, jerky or uncontrolled muscle movements, trouble breathing, or fainting.

Olanzapine side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using olanzapine and call your doctor at once if you have any of these serious side effects:

• fever, stiff muscles, sweating, fast or uneven heartbeats;
• jerky muscle movements you cannot control;
• sudden numbness or weakness, especially on one side of the body;
• sudden headache, confusion, problems with vision, speech, or balance;
• increased thirst, frequent urination, excessive hunger, or weakness;
• feeling light-headed, fainting;
• unusual thoughts or behavior, hallucinations, or thoughts about hurting yourself; or
• nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious side effects may include:

• dizziness, drowsiness, or weakness;
• constipation;
• dry mouth;
• swelling in your hands or feet;
• back pain;
• weight gain, increased appetite; or
• upset stomach.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

What other drugs will affect olanzapine?

Before using olanzapine, tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety). They can add to sleepiness caused by olanzapine.

The following drugs can interact with olanzapine. Tell your doctor if you are using any of these:

• a medication to treat high blood pressure or a heart condition;
• carbamazepine (Tegretol);
• fluvoxamine (Luvox); or
• a medication to treat Parkinson’s disease including levodopa (Sinemet, Larodopa, Atamet), selegiline (Eldepryl, Emsam), pramipexole (Mirapex), ropinirole (Requip), and others.

This list is not complete and there may be other drugs that can interact with olanzapine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

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