Warnings for special population
Pregnancy
This medicine is not recommended for use in pregnant women unless necessary. All the risks and benefits should be discussed with the doctor before taking this medicine.
Breast-feeding
This medicine is not recommended for use in breastfeeding women unless necessary. All the risks and benefits should be discussed with the doctor before taking this medicine. If the medicine is used, the infant should be monitored closely for any undesired side effects.
General warnings
Drug abuse
This medicine has a high potential for addiction and abuse even at recommended dosages, especially with prolonged use. Appropriate patient monitoring, safety precautions, and management of dose quantity are recommended to reduce the risk of drug abuse.
Bronchial Asthma
This medicine should be used with caution if you are suffering from an acute or chronic form of Bronchial asthma. Other diseases that might show asthma-like symptoms like Chronic Obstructive Pulmonary disease, Hypercapnia, Hypoxia should also be considered while prescribing this medication. Proper safety monitoring and dose adjustments should be done in such cases. It is advised to administer this medication in a monitored environment with equipment to handle any possible emergency.
Fall in blood pressure
This medicine can cause a temporary fall in blood pressure which can worsen based on posture (Orthostatic Hypotension). This can happen due to a pre-existing disease or other medications being administered at the same time. Proper clinical monitoring and dose adjustments are recommended in such cases. It should not be administered if you are suffering from severe heart ailments.
Impaired brain function
This medicine can increase the risk of side effects in patients suffering from a brain tumor or head injury. The dose should be adjusted based on the severity of impairment and the patient should be monitored in the initial stages of administration. It is not recommended for use in patients who are in a coma.
Other medicines
This combination medicine may interact with many other medicines and may cause severe adverse effects. Hence, it is advised that you inform the doctor about all your current medicines including any herbs and supplements before beginning treatment with this medicine.
Reduced fertility
Prolonged use of this medicine may reduce fertility in males and females in the reproductive age group. Patients should be informed about the potential effect on reproductive capabilities.
Suicidal Tendencies
This medicine should be used with caution due to the increased risk of suicidal tendencies. Patients should be closely monitored for any change in mood or behavior. Appropriate dose adjustments or replacement with a suitable alternative may be necessary based on the clinical condition.
Use in Elderly
This medicine should be done with extreme caution in elderly patients due to the increased risk of worsening the patient's condition. Appropriate dose adjustments or replacement with a suitable alternative may be required based on the clinical condition.
Use in children
This medicine is not recommended for use in patients less than 17 years of age since the safety and efficacy of use are not clinically established
Withdrawal symptoms
Abrupt discontinuation of this medicine may increase the risk of adverse effects, especially if you have been using a high dose for a long duration. A gradual dose reduction is recommended to avoid these reactions. Do not stop the use of this medicine without consulting your doctor.
Method of intake
This medicine should be taken as prescribed by the doctor. Use of this medicine without a prescription should be avoided. Never adopt other means like crushing the tablet and inhaling. These methods of intake can be fatal.
Driving or Operating machinery
Use of this medicine may cause dizziness or drowsiness in some patients. It is advised that you do not perform any activities that require high mental alertness like driving a vehicle or operating machinery if you experience any of these symptoms during treatment with this medicine.
Gastro-intestinal bleeding
This medicine may cause severe gastrointestinal bleeding and perforation after prolonged usage. These adverse events may occur with or without warning symptoms. This risk is especially higher in the elderly population and in patients with a history of gastrointestinal diseases. Appropriate dose adjustments or replacement with a suitable alternative may be required based on the clinical condition.
Heart surgery
This medicine should not be taken to relieve pain before, during, or after a coronary artery bypass graft surgery due to the increased risk of severe adverse reactions.
Kidney/Liver Disease
This medicine should be used with extreme caution in patients with kidney/liver impairment due to the increased risk of adverse effects. Regular monitoring of the kidney/liver function tests is necessary while receiving this medicine for such patients. Appropriate dose adjustments or replacement with a suitable alternative may be required in some cases based on the clinical condition.