SIDE EFFECTS: Dizziness, lightheadedness, nausea, constipation, drowsiness, itching, or dry mouth may occur. If any of these effects persist or worsen, contact your doctor or pharmacist promptly. Tell your doctor immediately if any of these serious side effects occur: increased pain, unusually fast or slow heartbeat, nervousness, headache, mental/mood changes, fever, redness or swelling at injection site, ringing in the ears. Tell your doctor immediately if any of these unlikely but serious side effects occur: trouble breathing, chest pain. If you notice other effects not listed above, contact your doctor or pharmacist.

PRECAUTIONS: Tell your doctor your medical history, especially of: heart problems (e.g., bradycardia, heart failure), blood pressure problems (e.g., hypertension, hypotension), depression, kidney disease, any allergies you may have. This medication is not recommended for use if you have the following medical conditions: infection at the injection site, bleeding problems. This drug may make you dizzy or drowsy; use caution engaging in activities requiring alertness such as driving or using machinery. Limit alcoholic beverages as they may aggravate side effects of this drug (e.g., dizziness, drowsiness). To minimize dizziness and lightheadedness, get up slowly when rising from a seated or lying position. Caution is advised when using this drug in the elderly because they may be more sensitive to the effects of the drug. This medication should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor. This medication passes into breast milk. Because of the potential risk to the infant, breast-feeding while using this drug is not recommended. Consult your doctor before breast-feeding.

DRUG INTERACTIONS: This drug is not recommended for use with "blood thinners" (e.g., heparin, warfarin). Ask your doctor or pharmacist for more details. Tell your doctor or pharmacist of all prescription and nonprescription drugs you may use, especially: beta-blockers (e.g., atenolol, metoprolol), calcium channel blockers (e.g., diltiazem, nifedipine, verapamil), psychiatric drugs (e.g., chlorpromazine, fluphenazine), tricyclic antidepressants (e.g., amitriptyline, imipramine, nortriptyline), digoxin, cyclosporine, other epidural medications (e.g., lidocaine). Also, report any drugs causing drowsiness, such as: medicine for sleep, sedatives, tranquilizers, anti-anxiety drugs (e.g. , diazepam), narcotic pain relievers (e.g., codeine, morphine), anti-seizure drugs (e.g., carbamazepine, phenobarbital), muscle relaxants, antihistamines that cause drowsiness (e.g., diphenhydramine). Check the labels on all your medicines (e.g., cough-and-cold products) because they may contain drowsiness-causing ingredients. Ask your pharmacist about the safe use of those products. Do not start or stop any medicine without doctor or pharmacist approval.

Report Problems to the Food and Drug Administration

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

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