methadone concentrate-oral (cont.)
PRECAUTIONS: Tell your doctor your medical history, especially of: stomach problems (e.g., colitis), substance abuse problems, uncorrected low mineral levels in the blood (e.g., potassium and magnesium), certain heart diseases (cardiac hypertrophy, cardiac conduction conditions--e.g., prolonged QT interval), any allergies. Use caution engaging in activities requiring alertness such as driving or using machinery. Alcoholic beverages may add to the effects of this medication causing dizziness or drowsiness. Ask your doctor or pharmacist about the use of alcohol. 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 drug is excreted into breast milk and may affect the infant. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: Tell your doctor of all prescription and nonprescription drugs you may be using, especially: MAO inhibitors (e.g., furazolidone, linezolid, phenelzine, selegiline, tranylcypromine), psychiatric drugs (e.g., desipramine), tranquilizers, sleeping pills (e.g., zolpidem), zidovudine, didanosine, stavudine, nevirapine, efavirenz, ritonavir, ritonavir/lopinavir, other narcotic pain relievers, drugs which affect certain liver enzymes (CYP 3A4 substrates, inhibitors, and inducers such as St John's wort, cimetidine, azole antifungals--itraconazole, macrolide antibiotics--erythromycin, rifamycins--rifampin, certain anti-seizure medications--phenobarbital, phenytoin, carbamazepine), certain antihistamines (e.g., diphenhydramine) or other drugs which can also cause drowsiness. Other drugs besides methadone which may affect the heart rhythm (QTc prolongation in the EKG) include dofetilide, pimozide, procainamide, quinidine, sotalol, sparfloxacin, "water pills" (diuretics such as furosemide), and laxatives among others. QTc prolongation can infrequently result in serious, rarely fatal, irregular heartbeats. Other symptoms my include unusual dizziness or fainting. Seek immediate medical attention should these occur. Consult your doctor or pharmacist for details. Ask for instructions about whether or not you need to stop any other QTc-prolonging drugs you may be using in order to minimize the risk of this effect. Do not start or stop any medicine without doctor or pharmacist approval.
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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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