Antidepressants may increase the risk of suicidal thoughts or actions in children, teenagers, and young adults. However, depression and certain other mental problems may also increase the risk of suicide. Talk with the patient’s doctor to be sure that the benefits of using Zoloft outweigh the risks.

Family and caregivers must closely watch patients who take Zoloft . It is important to keep in close contact with the patient’s doctor. Tell the doctor right away if the patient has symptoms like worsened depression, suicidal thoughts, or changes in behavior. Discuss any questions with the patient’s doctor

Zoloft is used for:

Treating depression or obsessive-compulsive disorder (OCD). It may be used to treat panic disorder or posttraumatic stress disorder (PTSD). It may also be used to treat premenstrual dysphoric disorder (PMDD; a severe form of premenstrual syndrome) or social anxiety disorder. It may also be used for other conditions as determined by your doctor.

Zoloft 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.

Do NOT use Zoloft if:

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

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

Before using Zoloft :

Some medical conditions may interact with Zoloft . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you or a family member has a history of bipolar disorder (manic-depression), other mental or mood problems, suicidal thoughts or attempts, or alcohol or substance abuse
• if you have a history of seizures, heart problems, liver problems, stomach or bowel bleeding, or metabolism problems
• if you are dehydrated, have low blood sodium levels, or drink alcohol
• if you will be having electroconvulsive therapy (ECT)

Some MEDICINES MAY INTERACT with Zoloft . Tell your health care provider if you are taking any other medicines, especially any of the following:

• Anorexiants (eg, phentermine), fenfluramine derivatives (eg, dexfenfluramine), linezolid, MAOIs (eg, phenelzine), metoclopramide, nefazodone, selegiline, serotonin 5-HT1 receptor agonists (eg, sumatriptan), sibutramine, St. John’s wort, or trazodone because severe side effects, such as a reaction that may include fever, rigid muscles, blood pressure changes, mental changes, confusion, irritability, agitation, delirium, and coma, may occur
• Anticoagulants (eg, warfarin), aspirin, or nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen) because the risk of bleeding, including stomach bleeding, may be increased
• Diuretics (eg, furosemide, hydrochlorothiazide) because the risk of blood sodium levels may be increased
• Tramadol because the risk of seizures may be increased
• H1 antagonists (eg, astemizole, terfenadine) or phenothiazines (eg, chlorpromazine, thioridazine) because severe heart problems, including irregular heartbeat, may occur
• Carbamazepine or cyproheptadine because they may decrease Zoloft ’s effectiveness
• Aripiprazole, clozapine, digoxin, flecainide, lithium, phenytoin, pimozide, propafenone, risperidone, tricyclic antidepressants (eg, amitriptyline), or valproate (eg, valproic acid) because the risk of their side effects may be increased by Zoloft

This may not be a complete list of all interactions that may occur. Ask your health care provider if Zoloft may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Zoloft :

Use Zoloft as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Zoloft comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Zoloft refilled.
• Take Zoloft by mouth with or without food.
• Taking Zoloft at the same time each day will help you remember to take it.
• Continue to take Zoloft even if you feel well. Do not miss any doses.
• Do not suddenly stop taking Zoloft without checking with your doctor. Side effects may occur. They may include mental or mood changes, numbness or tingling of the skin, dizziness, confusion, headache, trouble sleeping, or unusual tiredness. You will be closely monitored when you start Zoloft and whenever a change in dose is made.
• If you miss a dose of Zoloft , 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.

Ask your health care provider any questions you may have about how to use Zoloft .

Important safety information:

• Zoloft may cause drowsiness or dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use Zoloft 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 Zoloft .
• Check with your doctor before you use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Zoloft ; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
• Several weeks may pass before your symptoms improve. Do NOT take more than the recommended dose, change your dose, or use Zoloft for longer than prescribed without checking with your doctor.
• Children, teenagers, and young adults who take Zoloft may be at increased risk for suicidal thoughts or actions. Watch all patients who take Zoloft 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.
• If your doctor tells you to stop taking Zoloft , you will need to wait for several weeks before beginning to take certain other medicines (eg, MAOIs, nefazodone). Ask your doctor when you should start to take your new medicines after you have stopped taking Zoloft .
• Zoloft 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.
• Serotonin syndrome is a possibly fatal syndrome that can be caused by Zoloft . Your risk may be greater if you take Zoloft with certain other medicines (eg, "triptans," MAOIs). Symptoms may include agitation; confusion; hallucinations; coma; fever; fast or irregular heartbeat; tremor; excessive sweating; and nausea, vomiting, or diarrhea. Contact your doctor at once if you have any of these symptoms.
• Caution is advised when using Zoloft in the ELDERLY; they may be more sensitive to its effects, especially low blood sodium levels.
• Caution is advised when using Zoloft in CHILDREN; they may be more sensitive to its effects, especially increased risk of suicidal thoughts or actions.
• Zoloft should be used with extreme caution in CHILDREN younger than 6 years old; safety and effectiveness in these children have not been confirmed.
• Zoloft may cause weight changes. CHILDREN and teenagers may need regular weight and growth checks while they take Zoloft .
• PREGNANCY and BREAST-FEEDING: Zoloft may cause harm to the fetus if it is used during the last 3 months of pregnancy. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Zoloft while you are pregnant. It is not known if Zoloft is found in breast milk. If you are or will be breast-feeding while you use Zoloft , check with your doctor. Discuss any possible risks to your baby.

Possible side effects of Zoloft :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Anxiety; constipation; decreased sexual desire or ability; diarrhea; dizziness; drowsiness; dry mouth; increased sweating; loss of appetite; nausea; nervousness; stomach upset; tiredness; trouble sleeping; vomiting; weight loss.

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); bizarre behavior; black or bloody stools; chest pain; decreased bladder control; exaggerated reflexes; fast or irregular heartbeat; fever; hallucinations; loss of coordination; new or worsening agitation, panic attacks, aggressiveness, impulsiveness, irritability, hostility, exaggerated feeling of well-being, restlessness, or inability to sit still; persistent or severe ringing in the ears; 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.

This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider. You may report side effects to the FDA at 1-800-FDA-1088 (1-800-332-1088) or at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center ( http://www.aapcc.org/findyour.htm), or emergency room immediately. Symptoms may include coma; fainting; fast, slow, or irregular heartbeat; hair loss; hallucinations; seizures; severe or persistent dizziness, drowsiness, diarrhea, nausea, or vomiting; tremor.

Proper storage of Zoloft :

Store Zoloft at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Zoloft out of the reach of children and away from pets.

General information:

• If you have any questions about Zoloft , please talk with your doctor, pharmacist, or other health care provider.
• Zoloft is to be used only by the patient for whom it is prescribed. Do not share it with other people.
• If your symptoms do not improve or if they become worse, check with your doctor.

This information is summary only. It does not contain all information about Zoloft . If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Wellbutrin is used for:

Treating depression. It may also be used for other conditions as determined by your doctor.

Wellbutrin is an antidepressant. It works in the brain to treat depression. Exactly how it works is not known.

Do NOT use Wellbutrin if:

• you are allergic to any ingredient in Wellbutrin
• you are taking any other medicine that contains bupropion
• you have a history of an eating disorder (eg, anorexia, bulimia) or seizures (eg, epilepsy)
• you are suddenly stopping the use of alcohol or sedatives (eg, benzodiazepines) after long-term use
• you are taking or have taken a monoamine oxidase inhibitor (MAOI) (eg, phenelzine) within the last 14 days

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

Before using Wellbutrin :

Some medical conditions may interact with Wellbutrin . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you or a family member has a history of bipolar disorder (manic depression), other mental or mood problems (eg, depression), suicidal thoughts or attempts, or alcohol or substance abuse
• if you have diabetes, kidney problems, high blood pressure, heart problems (eg, congestive heart failure), or a recent heart attack
• if you have a history of seizure, head injury, tumor in the brain or spinal cord, or liver problems (eg, cirrhosis)

Some MEDICINES MAY INTERACT with Wellbutrin . Tell your health care provider if you are taking any other medicines, especially any of the following:

• Amantadine, antipsychotics (eg, haloperidol, risperidone), corticosteroids (eg, prednisone), insulin, levodopa, MAOIs (eg, phenelzine), nicotine patches, oral hypoglycemics (eg, glipizide), other antidepressants (eg, fluoxetine, amitriptyline), sympathomimetics (eg, pseudoephedrine), theophylline, or tiagabine because they may increase the risk of Wellbutrin ’s side effects
• Carbamazepine, phenobarbital, or phenytoin because they may decrease Wellbutrin ’s effectiveness
• Antiarrhythmics (eg, propafenone, flecainide), beta-blockers (eg, metoprolol), phenothiazines (eg, thioridazine), selective serotonin reuptake inhibitor (SSRI) antidepressants (eg, fluoxetine), or tricyclic antidepressants (eg, nortriptyline) because the risk of their side effects may be increased by Wellbutrin

This may not be a complete list of all interactions that may occur. Ask your health care provider if Wellbutrin may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Wellbutrin :

Use Wellbutrin as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Wellbutrin comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Wellbutrin refilled.
• Take Wellbutrin by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation.
• Several weeks may pass before your symptoms improve. Do not stop taking Wellbutrin without checking with your doctor.
• Take your doses at the same times each day at least 6 hours apart unless directed otherwise by your doctor. This may help to decrease the risk of seizures with Wellbutrin .
• Continue to take Wellbutrin even if you feel well. Do not miss any doses.
• If you miss a dose of Wellbutrin , skip the missed dose. Go back to your regular dosing schedule. Do not take more than 1 dose within 6 hours. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Wellbutrin .

Important safety information:

• Wellbutrin may cause drowsiness, dizziness, or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use Wellbutrin with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
• Check with your doctor before you drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are taking Wellbutrin ; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
• Wellbutrin may increase your risk of seizures. Your risk may be greater if you also have certain medical conditions, use certain medicines, or if you drink large amounts of alcohol. Talk to your doctor to see if you may have a greater risk of seizures while taking Wellbutrin .
• If you already drink alcohol or use sedatives, do not suddenly stop them without first checking with your doctor. Suddenly stopping them may increase your seizure risk.
• Do not take decongestants (eg, pseudoephedrine), stimulants, or diet pills while you are taking Wellbutrin without first checking with your doctor. They may increase your risk of seizures.
• The risk of seizures may be greater if you take Wellbutrin in high doses or for a long time. Do NOT take more than the recommended dose, change your dose, or use Wellbutrin for longer than prescribed without checking with your doctor.
• Children, teenagers, and young adults who take Wellbutrin may be at increased risk for suicidal thoughts or actions. Watch all patients who take Wellbutrin 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.
• If you have trouble sleeping, you may be taking your dose too close to bedtime. Talk with your doctor about changing your dosing schedule.
• Wellbutrin contains the same ingredients as Zyban, a medicine used to help stop smoking. Do not take Wellbutrin if you are also taking Zyban. Discuss any questions or concerns with your doctor.
• Use Wellbutrin with caution in the ELDERLY; they may be more sensitive to its effects.
• Wellbutrin should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.
• PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Wellbutrin while you are pregnant. Wellbutrin is found in breast milk. Do not breast-feed while taking Wellbutrin .

Possible side effects of Wellbutrin :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Constipation; dizziness; drowsiness; dry mouth; headache; increased sweating; loss of appetite; nausea; nervousness; restlessness; taste changes; trouble sleeping; vomiting; weight changes.

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); chest pain; confusion; delusions; fainting; fast or irregular heartbeat; fever, chills, or sore throat; hallucinations; hearing problems; menstrual changes; new or worsening mental or mood changes (eg, concentration problems, panic attacks, aggressiveness, agitation, anxiety, impulsiveness, irritability, hostility, exaggerated feeling of well-being or inability to sit still); red, swollen, blistered, or peeling skin; seizures; severe headache or dizziness; severe or persistent joint or muscle pain; severe or persistent nervousness, restlessness, or trouble sleeping; shortness of breath; suicidal thoughts or attempts; tremor; unusual swelling; vision changes; worsening depression.

This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider. You may report side effects to the FDA at 1-800-FDA-1088 (1-800-332-1088) or at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org/findyour.htm), or emergency room immediately. Symptoms may include chest pain; fast, slow, or irregular heartbeat; fever; hallucinations; loss of consciousness; rigid or painful muscles; seizures; severe dizziness; slow or difficult breathing.

Proper storage of Wellbutrin :

Store Wellbutrin at room temperature, between 59 and 77 degrees F (15 and 25 degrees C), in a tight, light-resistant container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Wellbutrin out of the reach of children and away from pets.

General information:

• If you have any questions about Wellbutrin , please talk with your doctor, pharmacist, or other health care provider.
• Wellbutrin is to be used only by the patient for whom it is prescribed. Do not share it with other people.
• If your symptoms do not improve or if they become worse, check with your doctor.

This information is a summary only. It does not contain all information about Wellbutrin . If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Remeron is used for:

Treating depression. It may also be used for other conditions as determined by your doctor.

Remeron is a tetracyclic antidepressant. How Remeron improves depression symptoms is not fully understood. It is thought to increase the activity of certain chemicals in the brain (norepinephrine, serotonin), which help elevate mood.

Do NOT use Remeron if:

• you are allergic to any ingredient in Remeron
• you are taking furazolidone
• you are taking or have taken a monoamine oxidase inhibitor (MAOI) (eg, phenelzine) within the last 14 days

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

Before using Remeron :

Some medical conditions may interact with Remeron . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have liver or kidney disease or a low white blood cell count, or have attempted or thought about suicide

Some MEDICINES MAY INTERACT with Remeron . Tell your health care provider if you are taking any other medicines, especially any of the following:

• Hydantoins (eg, phenytoin) because they may decrease Remeron ’s effectiveness
• Fluvoxamine, furazolidone, or MAOIs (eg, phenelzine) because side effects, such as nausea, dizziness, or seizures, may occur
• Fluvoxamine because it may increase the risk of Remeron ’s side effects
• Clonidine because it may decrease Remeron ’s effectiveness

This may not be a complete list of all interactions that may occur. Ask your health care provider if Remeron may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Remeron :

Use Remeron as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Remeron comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Remeron refilled.
• Take Remeron by mouth with or without food.
• Take Remeron in the evening before bedtime unless your doctor tells you otherwise.
• Improvement should be noticed within 1 to 4 weeks of taking Remeron .
• Continue to take Remeron even if you feel well. Do not miss any doses.
• If you miss a dose of Remeron , 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.

Ask your health care provider any questions you may have about how to use Remeron .

Important safety information:

• Remeron may cause drowsiness or dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use Remeron with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
• Children, teenagers, and young adults who take Remeron may be at increased risk for suicidal thoughts or actions. Watch all patients who take Remeron 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.
• Lab tests, including liver function, kidney function, and complete blood cell counts, may be performed while you use Remeron . These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
• Remeron should not be used in CHILDREN; safety and effectiveness in children have not been confirmed.
• PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Remeron while you are pregnant. It is not known if Remeron is found in breast milk. If you are or will be breast-feeding while you use Remeron , check with your doctor. Discuss any possible risks to your baby.

Possible side effects of Remeron :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Abnormal dreams; abnormal thinking; constipation; dizziness; drowsiness; dry mouth; flu symptoms; increased appetite; weakness; weight gain.

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); decreased ability to fight infection (fever, chills, sore throat); mental or mood changes; mouth sores; thoughts of hurting yourself; tremors; worsening of depression.

This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider. You may report side effects to the FDA at 1-800-FDA-1088 (1-800-332-1088) or at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org/findyour.htm), or emergency room immediately. Symptoms may include agitation; disorientation; drowsiness or deep sleep; fast heartbeat; impaired memory; loss of consciousness; rigid muscles; sluggishness.

Proper storage of Remeron :

Store Remeron at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Remeron out of the reach of children and away from pets.

General information:

• If you have any questions about Remeron , please talk with your doctor, pharmacist, or other health care provider.
• Remeron is to be used only by the patient for whom it is prescribed. Do not share it with other people.
• If your symptoms do not improve or if they become worse, check with your doctor.

This information is a summary only. It does not contain all information about Remeron . If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Prozac is used for:

Treating depression or obsessive-compulsive disorder (OCD) in adults and children. It is used to treat bulimia nervosa and panic disorder in adults. It may also be used for other conditions as determined by your doctor.

Prozac 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.

Do NOT use Prozac if:

• you are allergic to any ingredient in Prozac
• you are taking or have taken a monoamine oxidase inhibitor (MAOI) (eg, phenelzine), selegiline, or St. John’s wort within the last 14 days
• you are taking a fenfluramine derivative (eg, dexfenfluramine), an H1 antagonist (eg, astemizole, terfenadine), nefazodone, pimozide, a serotonin norepinephrine reuptake inhibitor (SNRI) (eg, venlafaxine), sibutramine, thioridazine, or tryptophan

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

Before using Prozac :

Some medical conditions may interact with Prozac . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you or a family member has a history of bipolar disorder (manic-depression), other mental or mood problems, suicidal thoughts or attempts, or alcohol or substance abuse
• if you have a history of seizures, heart problems, liver problems, severe kidney problems, stomach or bowel bleeding, diabetes, or metabolism problems
• if you are dehydrated, have low blood sodium levels, or drink alcohol
• if you will be having electroconvulsive therapy (ECT)

Some MEDICINES MAY INTERACT with Prozac . Tell your health care provider if you are taking any other medicines, especially any of the following:

• Anorexiants (eg, phentermine), fenfluramine derivatives (eg, dexfenfluramine), linezolid, MAOIs (eg, phenelzine), metoclopramide, nefazodone, selegiline, serotonin 5-HT1 receptor agonists (eg, sumatriptan), sibutramine, SNRIs (eg, venlafaxine, St. John’s wort, trazodone, or tryptophan because severe side effects, such as a reaction that may include fever, rigid muscles, blood pressure changes, mental changes, confusion, irritability, agitation, delirium, and coma, may occur
• Anticoagulants (eg, warfarin), aspirin, or nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen) because the risk of bleeding, including stomach bleeding, may be increased
• Diuretics (eg, furosemide, hydrochlorothiazide) because the risk of low blood sodium levels may be increased
• Tramadol because the risk of seizures may be increased
• Cyclobenzaprine or H1 antagonists (eg, astemizole, terfenadine) because severe heart problems, including irregular heartbeat, may occur
• HIV protease inhibitors (eg, ritonavir) because they may increase the risk of Prozac ’s side effects
• Cyproheptadine because it may decrease Prozac ’s effectiveness
• Aripiprazole, benzodiazepines (eg, alprazolam), beta-blockers (eg, propranolol), carbamazepine, clozapine, dextromethorphan, digoxin, flecainide, haloperidol, hydantoins (eg, phenytoin), lithium, norepinephrine reuptake inhibitors (eg, atomoxetine), phenothiazines (eg, chlorpromazine, thioridazine), pimozide, propafenone, risperidone, tricyclic antidepressants (eg, amitriptyline), or vinblastine because the risk of their side effects may be increased by Prozac

This may not be a complete list of all interactions that may occur. Ask your health care provider if Prozac may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Prozac :

Use Prozac as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Prozac comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Prozac refilled.
• Take Prozac by mouth with or without food.
• Taking Prozac at the same time each day will help you remember to take it.
• Continue to take Prozac even if you feel well. Do not miss any doses.
• Do not suddenly stop taking Prozac without checking with your doctor. Side effects may occur. They may include mental or mood changes, numbness or tingling of the skin, dizziness, confusion, headache, trouble sleeping, or unusual tiredness. You will be closely monitored when you start Prozac and whenever a change in dose is made.
• If you miss a dose of Prozac , 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.

Ask your health care provider any questions you may have about how to use Prozac .

Important safety information:

• Prozac may cause drowsiness or dizziness. These effects may be worse if you take it with alcohol or certain medicines. Take Prozac with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
• Check with your doctor before you drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are taking Prozac ; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
• Several weeks may pass before your symptoms improve. Do NOT take more than the recommended dose, change your dose, or take Prozac for longer than prescribed without checking with your doctor.
• Children, teenagers, and young adults who take Prozac may be at increased risk for suicidal thoughts or actions. Watch all patients who take Prozac 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.
• Diabetes patients - Prozac may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
• Serotonin syndrome is a possibly fatal syndrome that can be caused by Prozac . Your risk may be greater if you take Prozac with certain other medicines (eg, "triptans," MAOIs). Symptoms may include agitation; confusion; hallucinations; coma; fever; fast or irregular heartbeat; tremor; excessive sweating; and nausea, vomiting, or diarrhea. Contact your doctor at once if you have any of these symptoms.
• If your doctor tells you to stop taking Prozac , you will need to wait for several weeks before beginning to take certain other medicines (eg, MAOIs, nefazodone, thioridazine). Ask your doctor when you should start to take your new medicines after you have stopped taking Prozac .
• Prozac 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.
• Use Prozac with caution in the ELDERLY; they may be more sensitive to its effects, especially low blood sodium levels.
• Caution is advised when using Prozac in CHILDREN; they may be more sensitive to its effects, especially increased risk of suicidal thoughts or actions.
• Prozac should be used with extreme caution in CHILDREN younger than 7 years old; safety and effectiveness in these children have not been confirmed.
• Prozac may cause weight changes. CHILDREN and teenagers may need regular weight and growth checks while they take Prozac .
• PREGNANCY and BREAST-FEEDING: Prozac may cause harm to the fetus if it is used during the last 3 months of pregnancy. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Prozac while you are pregnant. Prozac is found in breast milk. Do not breast-feed while you are taking Prozac .

Possible side effects of Prozac :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Anxiety; decreased sexual desire or ability; diarrhea; dizziness; drowsiness; dry mouth; increased sweating; loss of appetite; nausea; nervousness; stomach upset; trouble sleeping; weakness.

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); bizarre behavior; black or bloody stools; chest pain; confusion; exaggerated reflexes; excessive sweating; fast or irregular heartbeat; fever, chills, or sore throat; hallucinations; increased urination; joint or wrist aches or pain; loss of coordination; new or worsening agitation, panic attacks, aggressiveness, impulsiveness, irritability, hostility, exaggerated feeling of well-being, restlessness, or inability to sit still; persistent or severe ringing in the ears;persistent, painful erection; red, swollen, blistered, or peeling skin; seizures; severe or persistent anxiety or trouble sleeping; significant weight loss; stomach pain; suicidal thoughts or attempts; tremor; unusual bruising or bleeding; unusual hoarseness; unusual or severe mental or mood changes; unusual swelling; vision changes; worsening of depression.

This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider. You may report side effects to the FDA at 1-800-FDA-1088 (1-800-332-1088) or at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org/findyour.htm), or emergency room immediately. Symptoms may include coma; confusion; delirium; difficult breathing; fainting; fast, slow, or irregular heartbeat; fever; seizures; severe or persistent dizziness, drowsiness, nausea, or vomiting; tremor.

Proper storage of Prozac :

Store Prozac at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Prozac out of the reach of children and away from pets.

General information:

• If you have any questions about Prozac , please talk with your doctor, pharmacist, or other health care provider.
• Prozac is to be used only by the patient for whom it is prescribed. Do not share it with other people.
• If your symptoms do not improve or if they become worse, check with your doctor.

This information is summary only. It does not contain all information about Prozac . If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Antidepressants may increase the risk of suicidal thoughts or actions in children, teenagers, and young adults. However, depression and certain other mental problems may also increase the risk of suicide. Talk with the patient’s doctor to be sure that the benefits of using Paxil outweigh the risks.

Family and caregivers must closely watch patients who take Paxil . It is important to keep in close contact with the patient’s doctor. Tell the doctor right away if the patient has symptoms like worsened depression, suicidal thoughts, or changes in behavior. Discuss any questions with the patient’s doctor.

Paxil is used for:

Treating depression or obsessive-compulsive disorder (OCD). It may be used to treat panic disorder or posttraumatic stress disorder (PTSD). It may also be used to treat generalized anxiety disorder or social anxiety disorder. It may also be used for other conditions as determined by your doctor.

Paxil 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.

Do NOT use Paxil if:

• you are allergic to any ingredient in Paxil
• you are taking or have taken a monoamine oxidase inhibitor (MAOI) (eg, phenelzine), selegiline, or St. John’s wort within the last 14 days
• you are taking a fenfluramine derivative (eg, dexfenfluramine), nefazodone, pimozide, a serotonin norepinephrine reuptake inhibitor (SNRI) (eg, venlafaxine), sibutramine, thioridazine, or tryptophan

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

Before using Paxil :

Some medical conditions may interact with Paxil . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you or a family member has a history of bipolar disorder (manic-depression), other mental or mood problems, suicidal thoughts or attempts, or alcohol or substance abuse
• if you have a history of seizures, heart problems, liver problems, severe kidney problems, stomach or bowel bleeding, narrow-angle glaucoma, diabetes, or metabolism problems
• if you are dehydrated, have low blood sodium levels, or drink alcohol
• if you will be having electroconvulsive therapy (ECT)

Some MEDICINES MAY INTERACT with Paxil . Tell your health care provider if you are taking any other medicines, especially any of the following:

• Anorexiants (eg, phentermine), cimetidine, fenfluramine derivatives (eg, dexfenfluramine), linezolid, lithium, MAOIs (eg, phenelzine), metoclopramide, nefazodone, selegiline, serotonin 5-HT1 receptor agonists (eg, sumatriptan), SNRIs (eg, venlafaxine), sibutramine, St. John’s wort, tramadol, trazodone, or tryptophan because severe side effects, such as a reaction that may include fever, rigid muscles, blood pressure changes, mental changes, confusion, irritability, agitation, delirium, and coma, may occur
• Anticoagulants (eg, warfarin), aspirin, or nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen) because the risk of bleeding, including stomach bleeding, may be increased
• Diuretics (eg, furosemide, hydrochlorothiazide) because the risk of blood sodium levels may be increased
• Antiarrhythmics (eg, flecainide, propafenone, quinidine), H1 antagonists (eg, astemizole, terfenadine), or phenothiazines (eg, chlorpromazine, thioridazine) because severe heart problems, including irregular heartbeat, may occur
• Cyproheptadine, HIV protease inhibitors (eg, ritonavir), phenobarbital, or phenytoin because they may decrease Paxil ’s effectiveness
• Aripiprazole, atomoxetine, clozapine, fluoxetine, pimozide, procyclidine, risperidone, theophylline, or tricyclic antidepressants (eg, amitriptyline) because the risk of their side effects may be increased by Paxil
• Digoxin because its effectiveness may be decreased by Paxil

This may not be a complete list of all interactions that may occur. Ask your health care provider if Paxil may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Paxil :

Use Paxil as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Paxil comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Paxil refilled.
• Take Paxil by mouth with or without food.
• Swallow Paxil whole. Do not break, crush, or chew before swallowing.
• Taking Paxil at the same time each day will help you remember to take it.
• Continue to take Paxil even if you feel well. Do not miss any doses.
• Do not suddenly stop taking Paxil without checking with your doctor. Side effects may occur. They may include mental or mood changes, numbness or tingling of the skin, dizziness, confusion, headache, trouble sleeping, or unusual tiredness. You will be closely monitored when you start Paxil and whenever a change in dose is made.
• If you miss a dose of Paxil , take it as soon as possible. If it almost time for your next dose, skip the missed dose. Go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Paxil .

Important safety information:

• Paxil may cause drowsiness, dizziness, or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use Paxil 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 Paxil .
• Check with your doctor before you use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Paxil ; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
• Several weeks may pass before your symptoms improve. Do NOT take more than the recommended dose, change your dose, or use Paxil for longer than prescribed without checking with your doctor.
• Children, teenagers, and young adults who take Paxil may be at increased risk for suicidal thoughts or actions. Watch all patients who take Paxil 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.
• If your doctor tells you to stop taking Paxil , you will need to wait for several weeks before beginning to take certain other medicines (eg, MAOIs, nefazodone). Ask your doctor when you should start to take your new medicines after you have stopped taking Paxil .
• Paxil 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.
• Serotonin syndrome is a possibly fatal syndrome that can be caused by Paxil . Your risk may be greater if you take Paxil with certain other medicines (eg, "triptans," MAOIs). Symptoms may include agitation; confusion; hallucinations; coma; fever; fast or irregular heartbeat; tremor; excessive sweating; and nausea, vomiting, or diarrhea. Contact your doctor at once if you have any of these symptoms.
• Caution is advised when using Paxil in the ELDERLY; they may be more sensitive to its effects, especially low blood sodium levels.
• Caution is advised when using Paxil in CHILDREN; they may be more sensitive to its effects, especially increased risk of suicidal thoughts and actions.
• Paxil should be used with extreme caution in CHILDREN; safety and effectiveness in these children have not been confirmed.
• Paxil may cause weight changes. CHILDREN and teenagers may need regular weight and growth checks while they take Paxil .
• PREGNANCY and BREAST-FEEDING: Paxil may cause harm to the fetus. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Paxil while you are pregnant. Paxil is found in breast milk. If you are or will be breast-feeding while you use Paxil , check with your doctor. Discuss any possible risks to your baby.

Possible side effects of Paxil :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Anxiety; blurred vision; constipation; decreased sexual desire or ability; diarrhea; dizziness; drowsiness; dry mouth; gas; increased sweating; increased urination; loss of appetite; nausea; nervousness; stomach upset; trouble concentrating; trouble sleeping; unusual skin sensations; weakness; yawning.

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); bizarre behavior; black or bloody stools; chest pain; exaggerated reflexes; fast or irregular heartbeat; fever, chills, or sore throat; hallucinations; loss of coordination; new or worsening agitation, panic attacks, aggressiveness, impulsiveness, irritability, hostility, exaggerated feeling of well-being, restlessness, or inability to sit still; persistent or severe ringing in the ears; persistent, painful erection; red, swollen, blistered, or peeling skin; seizures; severe or persistent anxiety or trouble sleeping; significant weight loss; stomach pain; suicidal thoughts or attempts; tremor; unusual bruising or bleeding; unusual or severe mental or mood changes; vision changes; worsening of depression.

This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider. You may report side effects to the FDA at 1-800-FDA-1088 (1-800-332-1088) or at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org/findyour.htm), or emergency room immediately. Symptoms may include coma; confusion; dilated pupils; fainting; fast, slow, or irregular heartbeat; inability to urinate; seizures; severe muscle pain; severe or persistent dizziness, drowsiness, nausea, or vomiting; tremor; yellowing of the eyes or skin.

Proper storage of Paxil :

Store Paxil at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Paxil out of the reach of children and away from pets.

General information:

• If you have any questions about Paxil , please talk with your doctor, pharmacist, or other health care provider.
• Paxil is to be used only by the patient for whom it is prescribed. Do not share it with other people.
• If your symptoms do not improve or if they become worse, check with your doctor.

This information is summary only. It does not contain all information about Paxil . If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Mobic is a nonsteroidal anti-inflammatory drug (NSAID). It may cause an increased risk of serious and sometimes fatal heart and blood vessel problems (eg, heart attack, stroke). The risk may be greater if you already have heart problems or if you take Mobic for a long time. Do not use Mobic right before or after bypass heart surgery.

Mobic may cause an increased risk of serious and sometimes fatal stomach ulcers and bleeding. Elderly patients may be at greater risk. This may occur without warning signs.

Mobic is used for:

Treating rheumatoid arthritis, osteoarthritis, and juvenile arthritis. It may also be used for other conditions as determined by your doctor.

Mobic is an NSAID. Exactly how it works is not known. It may block certain substances in the body that are linked to inflammation. NSAIDs treat the symptoms of pain and inflammation. They do not treat the disease that causes those symptoms.

Do NOT use Mobic if:

• you are allergic to any ingredient in Mobic
• you have had a severe allergic reaction (eg, severe rash, hives, trouble breathing, growths in the nose, dizziness) to aspirin or a nonsteroidal anti-inflammatory drug (NSAID) (eg, ibuprofen, celecoxib)
• you have recently had or will be having bypass heart surgery
• you have a peptic ulcer
• you are in the last 3 months of pregnancy

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

Before using Mobic :

Some medical conditions may interact with Mobic . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have a history of kidney or liver disease, diabetes, stomach or bowel problems (eg, bleeding, perforation, ulcers), or H. pylori infection
• if you have a history of swelling or fluid buildup, asthma, growths in the nose (nasal polyps), or mouth inflammation
• if you have high blood pressure, blood disorders, bleeding or clotting problems, heart problems (eg, heart failure), or blood vessel disease, or if you are at risk for any of these diseases
• if you have poor health, dehydration or low fluid volume, or low blood sodium levels, you drink alcohol, or you have a history of alcohol abuse

Some MEDICINES MAY INTERACT with Mobic . Tell your health care provider if you are taking any other medicines, especially any of the following:

• Anticoagulants (eg, warfarin), aspirin, corticosteroids (eg, prednisone), heparin, or selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine) because the risk of stomach bleeding may be increased
• Probenecid because it may increase the risk of Mobic ’s side effects
• Cholestyramine because it may decrease Mobic ’s effectiveness
• Cyclosporine, lithium, methotrexate, quinolones (eg, ciprofloxacin), or sulfonylureas (eg, glipizide) because the risk of their side effects may be increased by Mobic
• Angiotensin-converting enzyme (ACE) inhibitors (eg, enalapril), angiotensin receptor blockers (eg, losartan), or diuretics (eg, furosemide, hydrochlorothiazide) because their effectiveness may be decreased by this medicine and the risk of kidney problems may be increased

This may not be a complete list of all interactions that may occur. Ask your health care provider if Mobic may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Mobic :

Use Mobic as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Mobic comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Mobic refilled.
• Take Mobic by mouth. It may be taken with food if it upsets your stomach. Taking it with food may not lower the risk of stomach or bowel problems (eg, bleeding, ulcers). Talk with your doctor or pharmacist if you have persistent stomach upset.
• Take Mobic with a full glass of water (8 oz/240 mL) as directed by your doctor.
• If you take cholestyramine, ask your doctor or pharmacist how to take it with Mobic .
• If you miss a dose of Mobic , take it as soon as possible. If it is almost time for your next dose, skip the missed dose. Go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Mobic .

Important safety information:

• Mobic may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use Mobic with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
• Serious stomach ulcers or bleeding can occur with the use of Mobic . Taking it in high doses or for a long time, smoking, or drinking alcohol increases the risk of these side effects. Taking Mobic with food will NOT reduce the risk of these effects. Contact your doctor or emergency room at once if you develop severe stomach or back pain; black, tarry stools; vomit that looks like blood or coffee grounds; or unusual weight gain or swelling.
• Do NOT take more than the recommended dose or use for longer than prescribed without checking with your doctor.
• Mobic is an NSAID. Before you start any new medicine, check the label to see if it has an NSAID (eg, ibuprofen) in it too. If it does or if you are not sure, check with your doctor or pharmacist.
• Do not take aspirin while you are using Mobic unless your doctor tells you to.
• Lab tests, including kidney function, complete blood cell counts, and blood pressure, may be performed while you use Mobic . These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
• Use Mobic with caution in the ELDERLY; they may be more sensitive to its effects, especially stomach bleeding and kidney problems.
• Caution is advised when using Mobic in CHILDREN; they may be more sensitive to its effects, especially diarrhea, fever, headache, stomach pain, and vomiting.
• Mobic should be used with extreme caution in CHILDREN younger than 2 years old; safety and effectiveness in these children have not been determined.
• PREGNANCY and BREAST-FEEDING: Mobic may cause harm to the fetus. Do not use it during the last 3 months of pregnancy. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using Mobic while you are pregnant. It is not known if Mobic is found in breast milk. Do not breast-feed while taking Mobic .

Possible side effects of Mobic :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Constipation; diarrhea; dizziness; gas; headache; heartburn; nausea; stomach upset; trouble sleeping.

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

Severe allergic reactions (rash; hives; itching; trouble breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bloody or black, tarry stools; change in the amount of urine produced; chest pain; confusion; dark urine; depression; fainting; fast or irregular heartbeat; fever, chills, or persistent sore throat; mental or mood changes; numbness of an arm or leg; one-sided weakness; red, swollen, blistered, or peeling skin; ringing in the ears; seizures; severe headache or dizziness; severe or persistent stomach pain or nausea; severe vomiting; shortness of breath; sudden or unexplained weight gain; swelling of hands, legs, or feet; unusual bruising or bleeding; unusual joint or muscle pain; unusual tiredness or weakness; vision or speech changes; vomit that looks like coffee grounds; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider. You may report side effects to the FDA at 1-800-FDA-1088 (1-800-332-1088) or at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org/findyour.htm), or emergency room immediately. Symptoms may include chest pain; decreased urination; loss of consciousness; seizures; severe dizziness or drowsiness; severe nausea or stomach pain; slow or troubled breathing; unusual bleeding or bruising; vomit that looks like coffee grounds; yellowing of the eyes or skin.

Proper storage of Mobic :

Store Mobic at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Mobic out of the reach of children and away from pets.

General information:

• If you have any questions about Mobic , please talk with your doctor, pharmacist, or other health care provider.
• Mobic is to be used only by the patient for whom it is prescribed. Do not share it with other people.
• If your symptoms do not improve or if they become worse, check with your doctor.

This information is summary only. It does not contain all information about Mobic . If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Mobic is a nonsteroidal anti-inflammatory drug (NSAID). It may cause an increased risk of serious and sometimes fatal heart and blood vessel problems (eg, heart attack, stroke). The risk may be greater if you already have heart problems or if you take Mobic for a long time. Do not use Mobic right before or after bypass heart surgery.

Mobic may cause an increased risk of serious and sometimes fatal stomach ulcers and bleeding. Elderly patients may be at greater risk. This may occur without warning signs.

Mobic is used for:

Treating rheumatoid arthritis, osteoarthritis, and juvenile arthritis. It may also be used for other conditions as determined by your doctor.

Mobic is an NSAID. Exactly how it works is not known. It may block certain substances in the body that are linked to inflammation. NSAIDs treat the symptoms of pain and inflammation. They do not treat the disease that causes those symptoms.

Do NOT use Mobic if:

• you are allergic to any ingredient in Mobic
• you have had a severe allergic reaction (eg, severe rash, hives, trouble breathing, growths in the nose, dizziness) to aspirin or a nonsteroidal anti-inflammatory drug (NSAID) (eg, ibuprofen, celecoxib)
• you have recently had or will be having bypass heart surgery
• you have a peptic ulcer
• you are in the last 3 months of pregnancy

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

Before using Mobic :

Some medical conditions may interact with Mobic . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have a history of kidney or liver disease, diabetes, stomach or bowel problems (eg, bleeding, perforation, ulcers), or H. pylori infection
• if you have a history of swelling or fluid buildup, asthma, growths in the nose (nasal polyps), or mouth inflammation
• if you have high blood pressure, blood disorders, bleeding or clotting problems, heart problems (eg, heart failure), or blood vessel disease, or if you are at risk for any of these diseases
• if you have poor health, dehydration or low fluid volume, or low blood sodium levels, you drink alcohol, or you have a history of alcohol abuse

Some MEDICINES MAY INTERACT with Mobic . Tell your health care provider if you are taking any other medicines, especially any of the following:

• Anticoagulants (eg, warfarin), aspirin, corticosteroids (eg, prednisone), heparin, or selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine) because the risk of stomach bleeding may be increased
• Probenecid because it may increase the risk of Mobic ’s side effects
• Cholestyramine because it may decrease Mobic ’s effectiveness
• Cyclosporine, lithium, methotrexate, quinolones (eg, ciprofloxacin), or sulfonylureas (eg, glipizide) because the risk of their side effects may be increased by Mobic
• Angiotensin-converting enzyme (ACE) inhibitors (eg, enalapril), angiotensin receptor blockers (eg, losartan), or diuretics (eg, furosemide, hydrochlorothiazide) because their effectiveness may be decreased by this medicine and the risk of kidney problems may be increased

This may not be a complete list of all interactions that may occur. Ask your health care provider if Mobic may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Mobic :

Use Mobic as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Mobic comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Mobic refilled.
• Take Mobic by mouth. It may be taken with food if it upsets your stomach. Taking it with food may not lower the risk of stomach or bowel problems (eg, bleeding, ulcers). Talk with your doctor or pharmacist if you have persistent stomach upset.
• Take Mobic with a full glass of water (8 oz/240 mL) as directed by your doctor.
• If you take cholestyramine, ask your doctor or pharmacist how to take it with Mobic .
• If you miss a dose of Mobic , take it as soon as possible. If it is almost time for your next dose, skip the missed dose. Go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Mobic .

Important safety information:

• Mobic may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use Mobic with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
• Serious stomach ulcers or bleeding can occur with the use of Mobic . Taking it in high doses or for a long time, smoking, or drinking alcohol increases the risk of these side effects. Taking Mobic with food will NOT reduce the risk of these effects. Contact your doctor or emergency room at once if you develop severe stomach or back pain; black, tarry stools; vomit that looks like blood or coffee grounds; or unusual weight gain or swelling.
• Do NOT take more than the recommended dose or use for longer than prescribed without checking with your doctor.
• Mobic is an NSAID. Before you start any new medicine, check the label to see if it has an NSAID (eg, ibuprofen) in it too. If it does or if you are not sure, check with your doctor or pharmacist.
• Do not take aspirin while you are using Mobic unless your doctor tells you to.
• Lab tests, including kidney function, complete blood cell counts, and blood pressure, may be performed while you use Mobic . These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
• Use Mobic with caution in the ELDERLY; they may be more sensitive to its effects, especially stomach bleeding and kidney problems.
• Caution is advised when using Mobic in CHILDREN; they may be more sensitive to its effects, especially diarrhea, fever, headache, stomach pain, and vomiting.
• Mobic should be used with extreme caution in CHILDREN younger than 2 years old; safety and effectiveness in these children have not been determined.
• PREGNANCY and BREAST-FEEDING: Mobic may cause harm to the fetus. Do not use it during the last 3 months of pregnancy. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using Mobic while you are pregnant. It is not known if Mobic is found in breast milk. Do not breast-feed while taking Mobic .

Possible side effects of Mobic :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Constipation; diarrhea; dizziness; gas; headache; heartburn; nausea; stomach upset; trouble sleeping.

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

Severe allergic reactions (rash; hives; itching; trouble breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bloody or black, tarry stools; change in the amount of urine produced; chest pain; confusion; dark urine; depression; fainting; fast or irregular heartbeat; fever, chills, or persistent sore throat; mental or mood changes; numbness of an arm or leg; one-sided weakness; red, swollen, blistered, or peeling skin; ringing in the ears; seizures; severe headache or dizziness; severe or persistent stomach pain or nausea; severe vomiting; shortness of breath; sudden or unexplained weight gain; swelling of hands, legs, or feet; unusual bruising or bleeding; unusual joint or muscle pain; unusual tiredness or weakness; vision or speech changes; vomit that looks like coffee grounds; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider. You may report side effects to the FDA at 1-800-FDA-1088 (1-800-332-1088) or at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org/findyour.htm), or emergency room immediately. Symptoms may include chest pain; decreased urination; loss of consciousness; seizures; severe dizziness or drowsiness; severe nausea or stomach pain; slow or troubled breathing; unusual bleeding or bruising; vomit that looks like coffee grounds; yellowing of the eyes or skin.

Proper storage of Mobic :

Store Mobic at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Mobic out of the reach of children and away from pets.

General information:

• If you have any questions about Mobic , please talk with your doctor, pharmacist, or other health care provider.
• Mobic is to be used only by the patient for whom it is prescribed. Do not share it with other people.
• If your symptoms do not improve or if they become worse, check with your doctor.

This information is summary only. It does not contain all information about Mobic . If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Antidepressants may increase the risk of suicidal thoughts or actions in children, teenagers, and young adults. However, depression and certain other mental problems may also increase the risk of suicide. Talk with the patient’s doctor to be sure that the benefits of using Lexapro outweigh the risks.

Family and caregivers must closely watch patients who take Lexapro . It is important to keep in close contact with the patient’s doctor. Tell the doctor right away if the patient has symptoms like worsened depression, suicidal thoughts, or changes in behavior. Discuss any questions with the patient’s doctor.

Lexapro is used for:

Treating depression or generalized anxiety disorder. It may also be used for other conditions as determined by your doctor.

Lexapro 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.

Do NOT use Lexapro if:

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

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

Before using Lexapro :

Some medical conditions may interact with Lexapro . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you or a family member has a history of bipolar disorder (manic-depression), other mental or mood problems, suicidal thoughts or attempts, or alcohol or substance abuse
• if you have a history of seizures, liver problems, severe kidney problems, stomach or bowel bleeding, or metabolism problems
• if you are dehydrated, have low blood sodium levels, or drink alcohol
• if you will be having electroconvulsive therapy (ECT)

Some MEDICINES MAY INTERACT with Lexapro . Tell your health care provider if you are taking any other medicines, especially any of the following:

• Fenfluramine derivatives (eg, dexfenfluramine), linezolid, lithium, MAOIs (eg, phenelzine), metoclopramide, nefazodone, selegiline, serotonin 5-HT1 receptor agonists (eg, sumatriptan), sibutramine, St. John’s wort, or trazodone because severe side effects, such as a reaction that may include fever, rigid muscles, blood pressure changes, mental changes, confusion, irritability, agitation, delirium, and coma, may occur
• Anticoagulants (eg, warfarin), aspirin, or nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen) because the risk of bleeding, including stomach bleeding, may be increased
• Diuretics (eg, furosemide, hydrochlorothiazide) because the risk of low blood sodium levels may be increased
• Tramadol because the risk of seizures may be increased
• H1 antagonists (eg, astemizole, terfenadine) or phenothiazines (eg, chlorpromazine, thioridazine) because severe heart problems, including irregular heartbeat, may occur
• Carbamazepine or cyproheptadine because they may decrease Lexapro ’s effectiveness
• Clozapine, pimozide, risperidone, or tricyclic antidepressants (eg, amitriptyline) because the risk of their side effects may be increased by Lexapro

This may not be a complete list of all interactions that may occur. Ask your health care provider if Lexapro may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Lexapro :

Use this medicine as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Lexapro comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Lexapro refilled.
• Take Lexapro by mouth with or without food.
• Taking Lexapro at the same time each day will help you remember to take it.
• Continue to take Lexapro even if you feel well. Do not miss any doses.
• Do not suddenly stop taking Lexapro without checking with your doctor. Side effects may occur. They may include mental or mood changes, numbness or tingling of the skin, dizziness, confusion, headache, trouble sleeping, or unusual tiredness. You will be closely monitored when you start Lexapro and whenever a change in dose is made.
• If you miss a dose of Lexapro , 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.

Ask your health care provider any questions you may have about how to use Lexapro .

Important safety information:

• Lexapro may cause drowsiness or dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use Lexapro 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 Lexapro .
• Check with your doctor before you use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Lexapro ; 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 Lexapro for longer than prescribed without checking with your doctor.
• Children, teenagers, and young adults who take Lexapro may be at increased risk for suicidal thoughts or actions. Watch all patients who take Lexapro 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.
• Lexapro and a medicine called citalopram have the same active ingredient. Do not take Lexapro if you are also taking citalopram.
• If your doctor tells you to stop taking Lexapro , you will need to wait for several weeks before beginning to take certain other medicines (eg, MAOIs, nefazodone). Ask your doctor when you should start to take your new medicines after you have stopped taking Lexapro .
• Lexapro 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.
• Serotonin syndrome is a possibly fatal syndrome that can be caused by Lexapro . Your risk may be greater if you take Lexapro with certain other medicines (eg, "triptans," MAOIs). Symptoms may include agitation; confusion; hallucinations; coma; fever; fast or irregular heartbeat; tremor; excessive sweating; and nausea, vomiting, or diarrhea. Contact your doctor at once if you have any of these symptoms.
• Caution is advised when using Lexapro in the ELDERLY; they may be more sensitive to its effects, especially low blood sodium levels.
• Caution is advised when using Lexapro in CHILDREN; they may be more sensitive to its effects, especially increased risk of suicidal thoughts or actions.
• Lexapro should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.
• Lexapro may cause weight changes. CHILDREN and teenagers may need regular weight and growth checks while they take Lexapro .
• PREGNANCY and BREAST-FEEDING: Lexapro may cause harm to the fetus if it is used during the last 3 months of pregnancy. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Lexapro while you are pregnant. Lexapro is found in breast milk. Do not breast-feed while taking Lexapro .

Possible side effects of Lexapro :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Constipation; decreased sexual desire or ability; diarrhea; dizziness; drowsiness; dry mouth; headache; increased sweating; lightheadedness when you stand or sit up; loss of appetite; nausea; stomach upset; tiredness; trouble sleeping.

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); bizarre behavior; black or bloody stools; chest pain; confusion; decreased concentration; fast or irregular heartbeat; hallucinations; memory loss; menstrual period changes; new or worsening agitation, panic attacks, aggressiveness, impulsiveness, irritability, hostility, exaggerated feeling of well-being, restlessness, or inability to sit still; persistent or severe ringing in the ears;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.

This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider. You may report side effects to the FDA at 1-800-FDA-1088 (1-800-332-1088) or at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org/findyour.htm), or emergency room immediately. Symptoms may include coma; fast, slow, or irregular heartbeat; seizures; severe or persistent dizziness, drowsiness, nausea, or vomiting.

Proper storage of Lexapro :

Store Lexapro at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Lexapro out of the reach of children and away from pets.

General information:

• If you have any questions about Lexapro , please talk with your doctor, pharmacist, or other health care provider.
• Lexapro is to be used only by the patient for whom it is prescribed. Do not share it with other people.
• If your symptoms do not improve or if they become worse, check with your doctor.

This information is a summary only. It does not contain all information about Lexapro . Additionally, your doctor may have prescribed Lexapro for a use not mentioned above. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Antidepressants may increase the risk of suicidal thoughts or actions in children, teenagers, and young adults. However, depression and certain other mental problems may also increase the risk of suicide. Talk with the patient’s doctor to be sure that the benefits of using Elavil outweigh the risks.

Family and caregivers must closely watch patients who take Elavil . It is important to keep in close contact with the patient’s doctor. Tell the doctor right away if the patient has symptoms like worsened depression, suicidal thoughts, or changes in behavior. Discuss any questions with the patient’s doctor.

Elavil is used for:

Treating depression. It may also be used for other conditions as determined by your doctor.

Elavil is a tricyclic antidepressant. How tricyclic antidepressants improve depression symptoms is not fully understood. They are thought to increase the activity of certain chemicals in the brain (norepinephrine, serotonin), which help improve mood.

Do NOT use Elavil if:

• you are allergic to any ingredient in Elavil
• you are currently taking or have taken a monoamine oxidase inhibitor (MAOI) (eg, phenelzine, selegiline) within the last 14 days
• you are taking antihistamines (eg, diphenhydramine), cisapride, droperidol, a ketolide (eg, telithromycin) , a macrolide (eg, erythromycin), mibefradil, or pimozide
• you are recovering from a heart attack

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

Before using Elavil :

Some medical conditions may interact with Elavil . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have a history of mental illness (eg, bipolar disorder, mania, manic-depression), or have considered or attempted suicide
• if you have alcoholism or regularly consume 3 or more alcoholic beverages per day
• if you have glaucoma, an irregular heartbeat, heart disease, chest pain, liver disease, prostate problems, thyroid disease, or are unable to urinate (urinary retention)
• if you have a history of seizures, epilepsy, or porphyria

Some MEDICINES MAY INTERACT with Elavil . Tell your health care provider if you are taking any other medicines, especially any of the following:

• MAOIs (eg, phenelzine, selegiline) because they can cause serious, sometimes life-threatening, reactions. Do NOT take MAO inhibitors with, or within 2 weeks of taking, Elavil
• Anticholinergics (eg, scopolamine), bupropion, cimetidine, fluconazole, phenothiazines (eg, chlorpromazine), SSRIs (eg, fluoxetine), terbinafine, or valproic acid because side effects such as blurred vision, difficult urination, drowsiness or sedation, dry mouth, or lightheadedness may occur
• Antihistamines (eg, diphenhydramine), cisapride, droperidol, ketolides (eg, telithromycin), macrolides (eg, erythromycin), mibefradil, pimozide, or streptogramins (eg, quinupristin/dalfopristin) because serious side effects on the heart (eg, racing heartbeat, dizziness, fainting, life-threatening abnormal heartbeat leading to unconsciousness, and lack of heartbeat, may be increased by Elavil
• Carbamazepine, thyroid medicines (eg, levothyroxine), or stimulants (eg, albuterol, pseudoephedrine) because their side effects may be increased by Elavil
• Warfarin because side effects such as serious bleeding may be increased by Elavil
• Clonidine, guanethidine, or guanfacine because the effectiveness of these medicines may be decreased

This may not be a complete list of all interactions that may occur. Ask your health care provider if Elavil may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Elavil :

Use Elavil as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Elavil comes with an additional patient information sheet called a Medication Guide. Read it carefully and reread it each time you get Elavil refilled.
• Elavil may be taken with food or on an empty stomach.
• Avoid eating or drinking grapefruit juice while taking Elavil .
• Elavil may take up to 30 days to control symptoms of depression. Continue to use Elavil even if you feel well. Do not miss any doses.
• If you miss a dose of Elavil , 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.

Ask your health care provider any questions you may have about how to use Elavil .

Important safety information:

• Elavil may cause dizziness, drowsiness, or blurred vision. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Elavil . Using Elavil alone, with other medicines, or with alcohol may lessen your ability to drive or perform other potentially dangerous tasks.
• Avoid drinking alcohol or taking other medicines that cause drowsiness (eg, sedatives, tranquilizers) while taking Elavil . Elavil will add to the effects of alcohol and other depressants. Ask your pharmacist if you have questions about which medicines are depressants.
• Elavil may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
• Involuntary and uncontrollable movements may develop in patients taking Elavil . Occurrence is highest among the elderly, especially women. The risk of developing these involuntary movements and the likelihood they will become permanent are increased with long-term use and with high doses. However, it is possible to develop these symptoms after short-term use at low doses. Contact your health care provider at once if any of the following occur: involuntary movements of the tongue, face, mouth, or jaw (eg, protrusion of tongue, puffing of cheeks, puckering of mouth, chewing movements), sometimes accompanied by involuntary movements of the arms and legs.
• Elavil may cause sensitivity to sunlight. Avoid prolonged exposure to the sun and other ultraviolet light (eg, tanning beds). Use sunscreens and wear protective clothing until tolerance is determined.
• Do not become overheated in hot weather or during exercise or other activities since heatstroke may occur.
• Children, teenagers, and young adults who take Elavil may be at increased risk for suicidal thoughts or actions. Watch all patients who take Elavil 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.
• Diabetes patients - Elavil may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
• Before you have any medical or dental treatments, emergency care, or surgery, tell the doctor or dentist that you are using Elavil .
• Use caution in the ELDERLY; they may be more sensitive to its effects, especially lightheadedness upon standing; rapid heartbeat; breathing problems; difficult urination; and constipation.
• PREGNANCY and BREAST-FEEDING: Elavil has been shown to cause harm to the human fetus. If you plan on becoming pregnant, discuss with your doctor the benefits and risks of using Elavil during pregnancy. Elavil is excreted in the breast milk. Do not breast-feed while taking Elavil .

Possible side effects of Elavil :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Blurred vision; change in sexual desire or ability; constipation; diarrhea; dizziness; drowsiness; dry mouth; headache; loss of appetite; nausea; tiredness; trouble sleeping; weakness.

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); chest pain; confusion; dark urine; delusions; difficulty speaking or swallowing; fainting; fast or irregular heartbeat; fever, chills, or sore throat; hallucinations; new or worsening agitation, anxiety, panic attacks, aggressiveness, impulsiveness, irritability, hostility, exaggerated feeling of well-being, restlessness, or inability to sit still; numbness or tingling in an arm or leg; one-sided weakness; seizures; severe or persistent dizziness or headache; severe or persistent trouble sleeping; slurred speech; suicidal thoughts or actions; tremor; trouble urinating; uncontrolled muscle movements (eg, of face, tongue, arms, legs); unusual bleeding or bruising; unusual or severe mental or mood changes; vision problems; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider. You may report side effects to the FDA at 1-800-FDA-1088 (1-800-332-1088) or at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org/findyour.htm), or emergency room immediately. Symptoms may include flushing, fast or irregular heartbeat, dry mouth, drowsiness, confusion, agitation, enlarged pupils, seizures, loss of consciousness, hallucinations, stupor, mydriasis, hyperpyrexia, paralytic ileus, urinary retention, decreased GI motility, cardiovascular toxicity, rhabdomyolysis, renal failure, respiratory depression, cyanosis, shock, diaphoresis, aspiration, ARDS, hyperthermia, hypothermia, polyradiculoneuropathy, muscle rigidity, disorders of ocular motility, vomiting.

Proper storage of Elavil :

Store Elavil at room temperature, below 86 degrees F (30 degrees C) in a tightly closed container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Elavil out of the reach of children and away from pets.

General information:

• If you have any questions about Elavil , please talk with your doctor, pharmacist, or other health care provider.
• Elavil is to be used only by the patient for whom it is prescribed. Do not share it with other people.
• Do not use Elavil for other health conditions.
• If your symptoms do not improve or if they become worse, check with your doctor.
• If your symptoms do not improve after taking Elavil for 4 weeks, inform your doctor.
• If using Elavil for an extended period of time, obtain refills before your supply runs out.

This information is a summary only. It does not contain all information about Elavil . If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Antidepressants may increase the risk of suicidal thoughts or actions in children, teenagers, and young adults. However, depression and certain other mental problems may also increase the risk of suicide. Talk with the patient’s doctor to be sure that the benefits of using Effexor outweigh the risks.

Family and caregivers must closely watch patients who take Effexor . It is important to keep in close contact with the patient’s doctor. Tell the doctor right away if the patient has symptoms like worsened depression, suicidal thoughts, or changes in behavior. Discuss any questions with the patient’s doctor.

Effexor is used for:

Treating depression. It may also be used for other conditions as determined by your doctor.

Effexor is a serotonin and norepinephrine reuptake inhibitor (SNRI). It works by restoring the balance of certain natural substances in the brain (serotonin and norepinephrine), which helps to improve certain mood problems.

Do NOT use Effexor if:

• you are allergic to any ingredient in Effexor
• you are taking or have taken a monoamine oxidase inhibitor (MAOI) (eg, phenelzine), selegiline, or St. John’s wort within the last 14 days
• you are taking a fenfluramine derivative (eg, dexfenfluramine), sibutramine, or tryptophan

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

Before using Effexor :

Some medical conditions may interact with Effexor . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you or a family member has a history of bipolar disorder (manic-depression), other mental or mood problems, suicidal thoughts or attempts, or alcohol or substance abuse
• if you have a history of seizures, heart problems, (eg, heart failure, irregular heartbeat), abnormal electrocardiogram, recent heart attack, high blood pressure, overactive thyroid, liver problems, lung problems, kidney problems, stomach or bowel bleeding, increased eye pressure (eg, glaucoma), nervous system problems, or metabolism problems
• if you are dehydrated, have low blood sodium levels, or drink alcohol
• if you will be having electroconvulsive therapy (ECT)

Some MEDICINES MAY INTERACT with Effexor . Tell your health care provider if you are taking any other medicines, especially any of the following:

• Certain diet medicines (eg, phentermine, fenfluramine), linezolid, lithium, MAOIs (eg, phenelzine), metoclopramine, nefazodone, selegiline, selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine), serotonin and norepinephrine reuptake inhibitors (SNRIs) (eg, duloxetine), serotonin 5-HT1 receptor agonists (eg, sumatriptan), sibutramine,St. John’s wort, tramadol, trazodone, or tryptophan because severe side effects, such as a reaction that may include fever, rigid muscles, blood pressure changes, mental changes, confusion, irritability, agitation, delirium, and coma, may occur
• Nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen) because the risk of bleeding, including stomach bleeding, may be increased
• Diuretics (eg, furosemide, hydrochlorothiazide) because the risk of low blood sodium levels may be increased
• Cimetidine or ketoconazole because they may increase the risk of Effexor ’s side effects
• Cyproheptadine because it may decrease Effexor ’s effectiveness
• Aripiprazole, haloperidol, phenothiazines (eg, chlorpromazine, thioridazine), or risperidone because the risk of their side effects may be increased by Effexor

This may not be a complete list of all interactions that may occur. Ask your health care provider if Effexor may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Effexor :

Use Effexor as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Effexor comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Effexor refilled.
• Take Effexor by mouth with food.
• Effexor works best if it is taken at the same time each day.
• Continue to take Effexor even if you feel well. Do not miss any doses.
• Do not suddenly stop taking Effexor without checking with your doctor. Side effects may occur. They may include mental or mood changes, numbness or tingling of the skin, dizziness, drowsiness, confusion, headache, increased sweating, nausea, ringing in the ears, seizures, tremor, trouble sleeping, or unusual tiredness. You will be closely monitored when you start Effexor and whenever a change in dose is made.
• If you miss a dose of Effexor , 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.

Ask your health care provider any questions you may have about how to use Effexor .

Important safety information:

• Effexor may cause drowsiness, dizziness, or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use Effexor 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 Effexor .
• Do not use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Effexor without checking with your doctor; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
• Several weeks may pass before your symptoms improve. Do NOT take more than the recommended dose or use for longer than prescribed without checking with your doctor.
• Children, teenagers, and young adults who take Effexor may be at increased risk for suicidal thoughts or actions. Watch all patients who take Effexor 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.
• Serotonin syndrome is a possibly fatal syndrome that can be caused by Effexor . Your risk may be greater if you take Effexor with certain other medicines (eg, "triptans," MAOIs, SSRIs). Symptoms may include agitation; confusion; hallucinations; coma; fever; fast or irregular heartbeat; tremor; excessive sweating; and nausea, vomiting, or diarrhea. Contact your doctor at once if you have any of these symptoms.
• If your doctor tells you to stop taking Effexor , you will need to wait for a period of time before beginning to take certain other medicines (eg, MAOIs, nefazodone, thioridazine). Ask your doctor when you should start to take your new medicines after you have stopped taking Effexor .
• Effexor 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.
• Lab tests, including blood pressure and blood cholesterol levels, may be performed while you use Effexor . These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
• Use Effexor with caution in the ELDERLY; they may be more sensitive to its effects, especially low blood sodium levels.
• Caution is advised when using Effexor in CHILDREN; they may be more sensitive to its effects, especially increased risk of suicidal thoughts or actions.
• Effexor should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.
• Effexor may cause weight changes and growth changes. CHILDREN and teenagers may need regular weight and growth checks while they take Effexor .
• PREGNANCY and BREAST-FEEDING: Effexor may cause harm to the fetus if it is used during the last 3 months of pregnancy. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Effexor while you are pregnant. Effexor is found in breast milk. Do not breast-feed while taking Effexor .

Possible side effects of Effexor :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Anxiety; blurred vision; changes in taste; constipation; decreased sexual desire or ability; dizziness; drowsiness; dry mouth; flushing; headache; increased sweating; loss of appetite; nausea; nervousness; stomach upset; trouble sleeping; vomiting; weakness; weight loss; yawning.

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); bizarre behavior; chest pain or discomfort; confusion; decreased urination; fast or irregular heartbeat; fever, chills, or sore throat; new or worsening agitation, panic attacks, aggressiveness, impulsiveness, irritability, hostility, restlessness, or inability to sit still; persistent or severe ringing in the ears; seizures; severe or persistent anxiety, nervousness, or trouble sleeping; severe or persistent cough; severe or persistent headache, dizziness, or stomach pain; shortness of breath; significant weight loss; suicidal thoughts or attempts; tremor; unusual bruising or bleeding; unusual or severe mental or mood changes; vision problems; worsening of depression.

This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider. You may report side effects to the FDA at 1-800-FDA-1088 (1-800-332-1088) or at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org/findyour.htm), or emergency room immediately. Symptoms may include coma; dilated pupils; fainting; fast, slow, or irregular heartbeat; muscle pain or weakness; new or worsening mental or mood problems; seizures; severe or persistent dizziness, drowsiness, or trouble breathing; vomiting; yellowing of the eyes or skin.

Proper storage of Effexor :

Store Effexor at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Effexor out of the reach of children and away from pets.

General information:

• If you have any questions about Effexor , please talk with your doctor, pharmacist, or other health care provider.
• Effexor is to be used only by the patient for whom it is prescribed. Do not share it with other people.
• If your symptoms do not improve or if they become worse, check with your doctor.

This information is summary only. It does not contain all information about Effexor . If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Antidepressants may increase the risk of suicidal thoughts or actions in children, teenagers, and young adults. However, depression and certain other mental problems may also increase the risk of suicide. Talk with the patient’s doctor to be sure that the benefits of using Celexa outweigh the risks.

Family and caregivers must closely watch patients who take Celexa . It is important to keep in close contact with the patient’s doctor. Tell the doctor right away if the patient has symptoms like worsened depression, suicidal thoughts, or changes in behavior. Discuss any questions with the patient’s doctor.

Celexa is used for:

Treating depression. It may also be used for other conditions as determined by your doctor.

Celexa 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.

Do NOT use Celexa if:

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

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

Before using Celexa :

Some medical conditions may interact with Celexa . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you or a family member has a history of bipolar disorder (manic-depression), other mental or mood problems, suicidal thoughts or attempts, or alcohol or substance abuse
• if you have a history of seizures, liver problems, severe kidney problems, stomach or bowel bleeding, or metabolism problems
• if you are dehydrated, have low blood sodium levels, or drink alcohol
• if you will be having electroconvulsive therapy (ECT)

Some MEDICINES MAY INTERACT with Celexa . Tell your health care provider if you are taking any other medicines, especially any of the following:

• Fenfluramine derivatives (eg, dexfenfluramine), linezolid, lithium, MAOIs (eg, phenelzine), metoclopramide, nefazodone, selegiline, serotonin 5-HT1 receptor agonists (eg, sumatriptan), sibutramine, St. John’s wort, or trazodone because severe side effects, such as a reaction that may include fever, rigid muscles, blood pressure changes, mental changes, confusion, irritability, agitation, delirium, and coma, may occur
• Anticoagulants (eg, warfarin), aspirin, or nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen) because the risk of bleeding, including stomach bleeding, may be increased
• Diuretics (eg, furosemide, hydrochlorothiazide) because the risk of low blood sodium levels may be increased
• Tramadol because the risk of seizures may be increased
• H1 antagonists (eg, astemizole, terfenadine) or phenothiazines (eg, chlorpromazine, thioridazine) because severe heart problems, including irregular heartbeat, may occur
• Carbamazepine or cyproheptadine because they may decrease Celexa ’s effectiveness
• Clozapine, pimozide, risperidone, or tricyclic antidepressants (eg, amitriptyline) because the risk of their side effects may be increased by Celexa

This may not be a complete list of all interactions that may occur. Ask your health care provider if Celexa may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Celexa :

Use Celexa as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Celexa comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Celexa refilled.
• Take Celexa by mouth with or without food.
• Taking Celexa at the same time each day will help you remember to take it.
• Continue to take Celexa even if you feel well. Do not miss any doses.
• Do not suddenly stop taking Celexa without checking with your doctor. Side effects may occur. They may include mental or mood changes, numbness or tingling of the skin, dizziness, confusion, headache, trouble sleeping, or unusual tiredness. You will be closely monitored when you start Celexa and whenever a change in dose is made.
• If you miss a dose of Celexa , 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.

Ask your health care provider any questions you may have about how to use Celexa .

Important safety information:

• Celexa may cause drowsiness or dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use Celexa 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 Celexa .
• Check with your doctor before you use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Celexa ; 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 Celexa for longer than prescribed without checking with your doctor.
• Children, teenagers, and young adults who take Celexa may be at increased risk for suicidal thoughts or actions. Watch all patients who take Celexa 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.
• Celexa and a medicine called escitalopram have the same active ingredient. Do not take Celexa if you are also taking escitalopram.
• If your doctor tells you to stop taking Celexa , you will need to wait for several weeks before beginning to take certain other medicines (eg, MAOIs, nefazodone). Ask your doctor when you should start to take your new medicines after you have stopped taking Celexa .
• Celexa 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.
• Serotonin syndrome is a possibly fatal syndrome that can be caused by Celexa . Your risk may be greater if you take Celexa with certain other medicines (eg, "triptans," MAOIs). Symptoms may include agitation; confusion; hallucinations; coma; fever; fast or irregular heartbeat; tremor; excessive sweating; and nausea, vomiting, or diarrhea. Contact your doctor at once if you have any of these symptoms.
• Caution is advised when using Celexa in the ELDERLY; they may be more sensitive to its effects, especially low blood sodium levels.
• Caution is advised when using this medicine in CHILDREN; they may be more sensitive to its effects, especially increased risk of suicidal thoughts or actions.
• Celexa should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.
• Celexa may cause weight changes. CHILDREN and teenagers may need regular weight and growth checks while they take Celexa .
• PREGNANCY and BREAST-FEEDING: Celexa may cause harm to the fetus if it is used during the last 3 months of pregnancy. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Celexa while you are pregnant. Celexa is found in breast milk. Do not breast-feed while taking Celexa .

Possible side effects of Celexa :

All medicines may cause side effects, but many people have no, or minor, 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.

This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider. You may report side effects to the FDA at 1-800-FDA-1088 (1-800-332-1088) or at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org/findyour.htm), or emergency room immediately. Symptoms may include blue skin or lips; coma; confusion; fast breathing; fast, slow, or irregular heartbeat; memory loss; muscle pain; seizures; severe or persistent dizziness, drowsiness, nausea, or vomiting; tremor.

Proper storage of Celexa :

Store Celexa at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Celexa out of the reach of children and away from pets.

General information:

• If you have any questions about Celexa , please talk with your doctor, pharmacist, or other health care provider.
• Celexa is to be used only by the patient for whom it is prescribed. Do not share it with other people.
• If your symptoms do not improve or if they become worse, check with your doctor.

This information is a summary only. It does not contain all information about Celexa . If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.