Nuedexta Oral

Diarrhea, dizziness, cough, vomiting, weakness, or swelling in the hands/ankles/feet may occur. Infrequently, slight drowsiness may also occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
Tell your doctor right away if any of these serious side effects occur: easy bruising/bleeding, dark urine, muscle spasms, signs of infection (such as fever, persistent sore throat), stomach/abdominal pain, yellowing eyes/skin, lupus-like symptoms (joint/muscle pain, chest pain).
Get medical help right away if any of these serious side effects occur: fainting, fast/irregular heartbeat, severe dizziness.
This medication may rarely cause a very serious condition called serotonin syndrome. The risk increases when this medication is used with certain other drugs (see also Drug Interactions section). Get medical help right away if you develop some of the following symptoms: hallucinations, unusual restlessness, loss of coordination, fast heartbeat, unexplained fever, severe nausea/vomiting/diarrhea, twitching muscles.
A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
In the US -
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Before taking this medication, tell your doctor or pharmacist if you are allergic to dextromethorphan, quinidine, quinine, or mefloquine; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: blood/bone marrow disorder (such as low platelets/white blood cells/red blood cells), kidney disease, liver disease, lupus-like syndrome, myasthenia gravis.
Quinidine may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can infrequently result in serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away. The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may affect the heart rhythm. Before using quinidine, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, heart block, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).
Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/\"water pills\") or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using quinidine safely.
This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.
Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.
This medication may pass into breast milk. Consult your doctor before breast-feeding.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor\'s approval.
Some products that may interact with this drug include: fingolimod, propafenone.
This medication can slow down the removal of other medications from your body, which may affect how they work. Examples of affected drugs include aliskiren, digoxin, mefloquine, tricyclic antidepressants (such as desipramine, imipramine), among others.
Other medications can affect the removal of quinidine from your body, which may affect how quinidine works. Examples include mifepristone, certain azole antifungals (including fluconazole, itraconazole, posaconazole, voriconazole), certain protease inhibitors (such as nelfinavir, ritonavir, tipranavir), among others.
Avoid taking MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine) during treatment with this medication and for 2 weeks before and after treatment. In some cases a serious (possibly fatal) drug interaction may occur.
Many drugs besides quinidine may affect the heart rhythm (QT prolongation), including artemether/lumefantrine, ranolazine, toremifene, antiarrhythmic drugs (such as amiodarone, disopyramide, dofetilide, dronedarone, ibutilide, sotalol), antipsychotics (such as pimozide, thioridazine, ziprasidone), certain quinolone antibiotics (grepafloxacin, sparfloxacin), among others.
Before using this medication, report the use of other drugs that increase serotonin, such as lithium, St. John\'s wort, sibutramine, street drugs such as MDMA/\"ecstasy,\" tramadol, tryptophan, certain antidepressants including SSRIs (such as citalopram, paroxetine) and SNRIs (such as duloxetine, venlafaxine), \"triptans\" used to treat migraine headaches (such as eletriptan, sumatriptan), among others. The risk of serotonin syndrome may be more likely when you start or increase the dose of these medications.

If overdose is suspected, contact a poison control center or emergency room immediately. US residents can call the US National Poison Hotline at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe dizziness, fainting, fast/irregular heartbeat.

NOTES:
Do not share this medication with others.
Keep all regular medical and psychiatric appointments. Laboratory and/or medical tests (such as complete blood count, liver function) may be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

MISSED DOSE:
If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

STORAGE:
Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.
Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Information last revised July 2012. Copyright(c) 2012 First Databank, Inc.