Warnings for special population
Pregnancy
This medicine is not recommended for use in pregnant women except in life-threatening conditions. All the risks and benefits should be discussed with the doctor before taking this medicine. Your doctor may prescribe a safer alternative based on your clinical condition.
Breast-feeding
This medicine is not recommended for use in breastfeeding women unless absolutely necessary. All the risks and benefits should be discussed with the doctor before taking this medicine. Your doctor may advise you to discontinue breastfeeding or to discontinue the drug based on your clinical condition.
General warnings
Kidney disease and dialysis
This medicine should be administered with caution in patients with an impaired kidney function. Close monitoring of kidney function is recommended while receiving this medicine. Appropriate dose adjustments or replacement with a suitable alternative may be required in some cases based on the clinical condition.
Suicidal tendencies
Use of this medicine may cause suicidal ideation in some patients. Hence, it should be used with caution, especially in patients who have had such tendencies in the past and in patients with a history of psychological disorders. Close monitoring of mood and behavior is recommended for these patients. Appropriate dose adjustments or replacement with a suitable alternative may be necessary in some cases based on the clinical condition.
Driving or operating machinery
Use of this medicine may increase the risk of drowsiness, dizziness, difficulty in concentrating, etc. in some patients. Hence, it is advised that you do not perform any activities such as driving a vehicle or operating machinery if you experience any of these symptoms during treatment with this medicine.
Withdrawal symptoms
Use of this medicine should not be stopped abruptly as the risk of adverse effects are high if it is withdrawn suddenly. Do not stop the use of this medicine without consulting your doctor.
Edema
Use of this medicine can cause fluid retention in the body and hence should be used with caution in patients suffering from any fluid retention disorders. Appropriate dose adjustments or replacement with a suitable alternative may be required in some cases based on the clinical condition.
Heart block
Use of this medicine can cause heart rhythm abnormalities which could result in blockage and associated complications. Hence, it should be used with caution in patients having diseases of the heart and the blood vessels. Close monitoring of heart function and vital signs, appropriate dose adjustments, or replacement with a suitable alternative may be required in some cases based on the clinical condition.
Use in Children
This medicine is not recommended for use in patients less than 18 years of age since the safety and effectiveness of use are not clinically established.
Surgery
Use of this medicine is not recommended if you are planning to undergo a surgery in the near future. Consult your doctor in this regard, so that therapy with this medicine can be discontinued appropriately.
Bipolar disorder
This medicine is not recommended for use in patients suffering from a bipolar disorder since the symptoms of mania and depression may worsen upon usage of this medicine. Report any history of bipolar depression or mania to the doctor before receiving this medicine.
Liver diseases
This medicine should be administered with caution in patients with an impaired liver function. Close monitoring of liver function is recommended while using this medicine. Appropriate dose adjustments or replacement with a suitable alternative may be required in some cases based on the clinical condition.
Potential for abuse
Use of this medicine may cause dependence, especially in patients who are chronic alcohol users or have used other recreational drugs in the past. Report the past use of alcohol or other drugs to the doctor before receiving this medicine.
Rhabdomyolysis
Use of this medicine has been associated with rare cases of muscle breakdown disorders that affect kidneys. You should report any instance of muscle pain, weakness, the presence of dark reddish coloration of urine, etc. to the doctor on priority. Appropriate dose adjustments or replacement with a suitable alternative may be required in some cases based on the clinical condition.