Drug Ingredient Information
DESVENLAFAXINE-50MG+CLONAZEPAM-0.5MG
DESVENLAFAXINE
| Information for
patients
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| Drug Information |
Desvenlafaxine is an antidepressant (serotonin-norepinephrine reuptake inhibitor type-SNRI) used in the treatment of depression. It works by restoring the balance of natural substances (neurotransmitters such as serotonin and norepinephrine) in the brain. Desvenlafaxine may improve your mood, feelings of well-being, and energy level. This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.
Venlafaxine is very similar to desvenlafaxine. Venlafaxine has been used to treat anxiety and panic attacks. |
| Drug Alert |
| Alert |
Antidepressant medications are used to treat a variety of conditions, including depression and other mental/mood disorders. These medications can help prevent suicidal thoughts/attempts and provide other important benefits. However, studies have shown that a small number of people (especially people younger than 25) who take antidepressants for any condition may experience worsening depression, other mental/mood symptoms, or suicidal thoughts/attempts. Therefore, it is very important to talk with the doctor about the risks and benefits of antidepressant medication (especially for people younger than 25), even if treatment is not for a mental/mood condition.
Tell the doctor immediately if you notice worsening depression/other psychiatric conditions, unusual behavior changes (including possible suicidal thoughts/attempts), or other mental/mood changes (including new/worsening anxiety, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, very rapid speech). Be especially watchful for these symptoms when a new antidepressant is started or when the dose is changed. |
| Before Consuming
the Medicine
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| Avoid Drug |
Avoid drinking alcohol, which can increase some of the side effects of desvenlafaxine.
Tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures or anxiety). They can add to sleepiness caused by desvenlafaxine.
Desvenlafaxine can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. |
| Drug Special Care |
Before taking desvenlafaxine, tell your doctor or pharmacist if you are allergic to it; or to venlafaxine; 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: personal or family history of psychiatric disorders (e.g., bipolar/manic-depressive disorder), personal or family history of suicide attempts, bleeding problems, glaucoma, high blood pressure, heart problems (such as chest pain, heart failure, heart attack), history of stroke, high cholesterol, kidney disease, liver disease, seizure disorder, low sodium in the blood (hyponatremia).
This drug may make you dizzy or drowsy or cause blurred vision. Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely. Avoid alcoholic beverages.
Kidney function declines as you grow older. This medication is removed by the kidneys. Therefore, older adults may be at greater risk for side effects (e.g., bleeding) while using this drug. The elderly are more likely to lose too much salt (hyponatremia), especially if they are also taking "water pills" (diuretics) with this medication.
Based on information for a similar drug (venlafaxine), this drug may affect growth rate in children. Therefore, caution is advised if this drug is used in children. Monitor your child's height and growth rate. Consult your doctor or pharmacist for more details.
Use this medication only when clearly needed during pregnancy. It may harm an unborn baby. Also, babies born to mothers who have used this drug during the last 3 months of pregnancy may infrequently develop withdrawal symptoms such as feeding/breathing difficulties, seizures, muscle stiffness, or constant crying. If you notice any of these symptoms in your newborn, tell the doctor promptly.
Since untreated depression can be a serious condition, do not stop taking this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, immediately discuss the benefits and risks of using this medication during pregnancy with your doctor.
This drug passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding. |
| Drug Drug Interactions |
Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.
Taking certain medications with this product could result in serious (rarely fatal) drug interactions. Avoid taking MAO inhibitors (furazolidone, isocarboxazid, linezolid, moclobemide, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine) for 2 weeks before treatment, during treatment, and for at least 7 days after your last dose of desvenlafaxine. Consult your doctor or pharmacist for more information.
This drug should also not be used with the following medications because very serious (rarely fatal) interactions may occur: weight loss drugs (e.g., sibutramine, phentermine), tryptophan.
If you are currently using any of these medications, tell your doctor or pharmacist before starting desvenlafaxine.
Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: drugs that can cause bleeding/bruising (e.g., aspirin, antiplatelet drugs such as clopidogrel, NSAIDs such as ibuprofen, "blood thinners" such as heparin/warfarin).
Desvenlafaxine is very similar to venlafaxine. Do not use medications containing venlafaxine while using desvenlafaxine.
Aspirin can increase the risk of bleeding when used with this medication (see above). If your doctor has directed you to take low-dose aspirin for heart attack or stroke prevention (usually at dosages of 81-325 milligrams a day), you should continue taking it unless your doctor instructs you otherwise. Discuss the risks and benefits with your doctor.
Also tell your doctor if you take any other drugs that increase serotonin, such as buspirone, dextromethorphan, lithium, meperidine, propoxyphene, SSRIs, other SNRIs, St. John's wort, drugs used to treat migraines such as "triptans" and dihydroergotamine, street drugs such as MDMA/"ecstasy," amphetamine. (See also Side Effects section.)
This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. |
| Drug Pregnancy Interaction |
Since untreated depression can be a serious condition, do not stop taking this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, immediately discuss the benefits and risks of using this medication during pregnancy with your doctor. |
| Drug Breast feeding Interaction |
This drug passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding. |
| Drug Machinery Interaction |
no data available |
| Drug More Information |
no data available |
| How to take the
Medicine
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| Consumption Info |
no data available |
| Drug quanitty |
no data available |
| Drug Dose |
Read the Medication Guide provided by your pharmacist before you start using desvenlafaxine and each time you get a refill. If you have any questions, consult your doctor or pharmacist.
Take this medication with or without food, usually once daily or as directed by your doctor. Dosage is based on your medical condition and response to treatment.
Do not crush, chew, or dissolve this medication in water. Doing so can release all of the drug at once, increasing the risk of side effects. Also, do not split the tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing.
To reduce your risk of side effects, your doctor may direct you to start taking this drug at a low dose and slowly increase your dose. Follow your doctor's instructions carefully. Do not take more or less medication or take it more frequently than prescribed. Your condition will not improve any faster, and your risk of side effects will increase. Use this medication regularly in order to get the most benefit from it. To help you remember, use it at the same time each day.
It is important to continue taking this medication even if you feel well. Do not stop taking this medication without consulting your doctor. If you suddenly stop this drug, especially if it has been used for an extended time or in high doses, you may experience symptoms (withdrawal reactions) such as mood swings, headache, tiredness, sleep changes, and brief feelings similar to mild electric shock. To prevent these symptoms while you are stopping treatment with this drug, your doctor may reduce your dose slowly. Consult your doctor or pharmacist for more details, and report any withdrawal reactions immediately.
If you are switching from another antidepressant to desvenlafaxine, your doctor should slowly reduce the dose of your old antidepressant to prevent withdrawal reactions from the other antidepressant. Ask your doctor or pharmacist for more details.
It may take several weeks to feel the full benefit of this medication. Tell your doctor if your condition persists or worsens. |
| Excess Drug Consumption |
If overdose is suspected, contact your local 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 drowsiness, seizures, fast/irregular heartbeat.
NOTES: Do not share this medication with others.
Psychiatric/medical check-ups or lab tests (e.g., blood pressure, cholesterol, growth monitoring in children) should be done periodically to monitor your progress or check for side effects. Consult your doctor for more details. |
| Forgot Drug Consumption |
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. |
| Stop Drug Consumption |
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| Possible Side
Effects
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| General Information |
no data available |
| Common Drug Side Effects |
Drowsiness, dizziness, nausea, dry mouth, constipation, loss of appetite, weight loss, blurred vision, nervousness, trouble sleeping, or excessive sweating may occur. If any of these effects persist or worsen, tell your doctor promptly.
Desvenlafaxine may increase blood pressure. Your blood pressure should be checked regularly while you are taking this medication.
An empty tablet shell may appear in your stool. This is harmless.
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 immediately if any of these unlikely but serious side effects occur: severe/pounding headache, shakiness (tremor), decreased interest in sex, changes in sexual ability.
Tell your doctor immediately if any of these rare but very serious side effects occur: chest pain, persistent cough, shortness of breath, black/tarry stools, vomit that looks like coffee grounds, easy bruising/bleeding, seizures, change in the amount of urine.
This medication may rarely cause a very serious condition called serotonin syndrome. The risk increases when this medication is used with certain other drugs such as "triptans" used to treat migraine headaches (e.g., sumatriptan, eletriptan), certain antidepressants including SSRIs (e.g., citalopram, paroxetine) and other SNRIs (e.g., duloxetine), lithium, tramadol, tryptophan, or a certain drug to treat obesity (sibutramine). See also Drug Interactions section. Before taking this drug, tell your doctor if you take any of these medications. Serotonin syndrome may be more likely when you start or increase the dose of any of these medications. Seek immediate medical attention if you develop some of the following symptoms: hallucinations, restlessness, loss of coordination, fast heartbeat, severe dizziness, unexplained fever, severe nausea/vomiting/diarrhea, twitchy muscles.
A very serious allergic reaction to this drug is rare. However, seek immediate medical attention 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. |
| Rare Drug Side Effects |
no data available |
| Very Rare Drug Side Effects |
no data available |
| Drug Side Effects Symptoms |
no data available |
| How to Store the
Medicine
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| How to Store the Medicine |
Store at room temperature between 68-77 degrees F (20-25 degrees C) away from light and moisture. Do not store in the bathroom. Keep all medicines 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 for more details about how to safely discard your product. |
CLONAZEPAM
| Information for
patients
|
| Drug Information |
It contains a medicine called clonazepam. This belongs to a group of medicines called ‘benzodiazepines’.
Clonazepam is used to treat epilepsy in infants, children and adults.
•It lowers the number of fits (seizures) that you have.
•Any fits that you do have will be less serious. |
| Drug Alert |
| Alert |
•Clonazepam or any of the other ingredients of Clonazepam.
•Other ‘benzodiazepine’ medicines. These include diazepam, flurazepam and temazepam. Do not take Clonazepam if any of the above apply to you. If you are not sure, talk to your doctor or pharmacist before taking Clonazepam. |
| Before Consuming
the Medicine
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| Avoid Drug |
•You have breathing problems or lung disease.
•You have severe liver problems.
•You have a condition called ‘myasthenia gravis’ (where your muscles become weak and get tired easily).
•You have a condition called ‘sleep apnoea syndrome’ (where your breathing stops when you are asleep). Do not take Clonazepam if any of the above apply to you. If you are not sure, talk to your doctor or pharmacist before taking Clonazepam. |
| Drug Special Care |
A small number of people being treated with anti-epileptics such as clonazepam have had thoughts of harming or killing themselves. If at any time you have these thoughts, immediately contact your doctor. Check with your doctor or pharmacist before taking Clonazepam if:
•You have liver, kidney or lung problems.
•You have ever had depression.
•You have ever tried to kill yourself.
•A close friend or relative has recently died.
•You regularly drink alcohol or take recreational drugs or you have had problems with alcohol or drug use in the past.
•You have spinal or cerebellar ataxia (where you may become shaky and unsteady, have slurred speech or rapid eye movements).
•You have a rare, inherited blood problem called ‘porphyria’.
If any of the above apply to you, or if you are not sure, talk to your doctor or pharmacist before you take Clonazepam. |
| Drug Drug Interactions |
Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines. This includes medicines that you buy without a prescription and herbal medicines. This is because Clonazepam can affect the way some other medicines work. Also some other medicines can affect the way Clonazepam works.In particular, tell your doctor or pharmacist if you are taking any of the following medicines:
•Other medicines to treat epilepsy, such as carbamazepine, hydantoins, phenobarbital, phenytoin, primidone or sodium valproate.
•Cimetidine (used to treat stomach problems and heartburn).
•Rifampicin (an antibiotic used to treat infections).
•Medicines used to make you sleep (hypnotics).
•Medicines that help with anxiety (tranquillisers).
•Pain-killers (analgesics) and medicines to relax your muscles (muscle relaxants).
Operations
If you are going to have an anaesthetic for an operation or for dental treatment, it is important to tell your doctor or dentist that you are taking Clonazepam. |
| Drug Pregnancy Interaction |
Do not take Clonazepam if you are pregnant, might become pregnant or are breast-feeding, unless your doctor tells you to. This is because Clonazepam will affect your baby. |
| Drug Breast feeding Interaction |
Do not take Clonazepam if you are pregnant, might become pregnant or are breast-feeding, unless your doctor tells you to. This is because Clonazepam will affect your baby. |
| Drug Machinery Interaction |
Talk to your doctor about driving and using machines or tools, whilst you are taking Clonazepam. This is because it can slow down your reactions, particularly when you start taking it. If you are in any doubt about whether you can do a particular activity, talk to your doctor |
| Drug More Information |
Do not drink alcohol while you are taking Clonazepam. This is because it may cause side effects or cause your fits to return. |
| How to take the
Medicine
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| Consumption Info |
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| Drug quanitty |
Adults and children over 12 years
•The usual starting dose is 1 mg a day, or less.
•This will be increased gradually (usually to between 4 mg and 8 mg a day). The maximum dose is 20 mg a day.
The elderly
•The usual starting dose is 0.5 mg a day, or less.
•This will be increased gradually (usually to between 4 mg and 8 mg a day). The maximum dose is 20 mg a day.
Infants (aged 0 to 1 year)
•The usual starting dose is 0.25 mg a day, or less.
•This will be increased gradually (usually to between 0.5 mg and 1 mg a day).
Small children (aged 1 to 5 years)
•The usual starting dose is 0.25 mg a day, or less.
•This will be increased gradually (usually to between 1 mg and 3 mg a day).
Older children (aged 5 to 12 years)
•The usual starting dose is 0. 5 mg a day, or less.
•This will be increased gradually (usually to between 3 mg and 6 mg a day). |
| Drug Dose |
Always take Clonazepam exactly as your doctor has told you. You should check with your doctor if you are not sure.
•Your doctor will start you on a low dose of Clonazepam and gradually increase it over 2 to 4 weeks until the right dose has been found for you.
•Your doctor will usually tell you to split your daily dose into three equal amounts which you will take at evenly spaced times throughout the day.
•If the daily dose cannot be split equally, take the largest dose at bedtime.
•Once your doctor has found the right dose for you, they may tell you to take Clonazepam as a single dose in the evening. |
| Excess Drug Consumption |
•If you take more Clonazepam than you should, talk to a doctor or go to a hospital straight away. Take the medicine pack with you.
•If you take too many tablets, you may feel drowsy, sleepy, light-headed, have a lack of co-ordination or be less responsive than normal. |
| Forgot Drug Consumption |
•If you forget to take a dose, skip the missed dose. Then take the next dose when it is due.
•Do not take a double dose (two doses at the same time) to make up for a forgotten dose. |
| Stop Drug Consumption |
•Do not stop taking your tablets without talking to your doctor. If you do, your fits may return and you may get withdrawal symptoms (see Section 4: Possible side effects).
•If the dose of Clonazepam you take has to be reduced, or stopped, this must be done gradually. Your doctor will let you know how to do this.If someone else takes your Clonazepam tablets by mistake, they should talk to a doctor or go to a hospital straight away.If you have any further questions on the use of this medicine, ask your doctor or pharmacist. |
| Possible Side
Effects
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| General Information |
•Poor concentration, confusion and a feeling of being lost (disorientation).
•Feeling restless.
•Difficulty remembering new things.
•Headache.
•Depression.
•Slowing or slurring of speech.
•Poor co-ordination, including feeling unsteady when walking.
•An increase in how often you have fits.
Liver, kidney and blood
•Changes in how well your liver is working (shown by blood tests).
•Loss of bladder control.
•Blood problems. The signs include feeling tired, bruising easily, being short of breath and nose bleeds. Your doctor may want you to have blood tests from time to time.
Stomach and gut
•Feeling sick (nausea).
•Stomach upset.
Eyes
•Double vision.
•Jerky movements of the eyes (nystagmus).
Skin and hair
•Skin rashes and itchy skin.
•Changes to the colour of your skin.
•Hair loss (the hair usually grows back).
Sexual
•Loss of sex drive.
•Difficulty getting or keeping an erection (erectile dysfunction). |
| Common Drug Side Effects |
Allergic reactions
If you get an allergic reaction, see a doctor straight away.
The signs may include:
•Sudden swelling of the throat, face, lips and mouth. This may make it difficult to breathe or swallow.
•Sudden swelling of the hands, feet and ankles.
•Skin rash or itching.
Effects on the heart
If you notice any of the following effects, see a doctor straight away.The signs may include:
•Breathlessness, swelling of the ankles, cough, tiredness and a racing heart.
•Chest pain which may spread to your neck and shoulders and down your left arm.
Effects on behaviour
If you notice any of the following effects, talk to your doctor as they may want you to stop taking Clonazepam. The signs may include:
•Being aggressive, excited, irritable, nervous, agitated, or anxious.
•Problems sleeping, nightmares and vivid dreams.
•Mental problems such as seeing or hearing things that are not really there (hallucinations), delusions (believing in things that are not real) and problems with your speech.
•Types of fits (seizures) that you have not had before.
Infants and children
•If an infant or small child is taking Clonazepam, watch them carefully. This is because they could develop breathing problems, coughing or choking. This can be caused by too much saliva being made.
•Early puberty in children. This is reversible after stopping treatment with Clonazepam.
Elderly patients
Older patients taking benzodiazepine medicines have a higher risk of falling and breaking bones. |
| Rare Drug Side Effects |
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| Very Rare Drug Side Effects |
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| Drug Side Effects Symptoms |
Using benzodiazepines like Clonazepam may make you dependent on the medicine. This means that if you stop treatment quickly, or reduce the dose too quickly, you may get withdrawal symptoms. The symptoms can include:
•Problems sleeping.
•Muscle pain, shaking (tremor) and feeling restless.
•Feeling very anxious, tense, confused, irritable or agitated, or changes in your mood.
•Increased sweating.
•Headache.
•Feeling sensitive to light, noise and physical contact.
•Seeing or hearing things that are not really there (hallucinations).
•Tingling and feeling numb in your arms and legs.
•A feeling of losing contact with reality. |
| How to Store the
Medicine
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| How to Store the Medicine |
•Keep Clonazepam tablets in their original bottle and in the outer carton to protect from light.
•Clonazepam tablets do not need special storage conditions.
•Keep out of the reach and sight of children.
•Do not use Clonazepam after the expiry date printed on the pack.
•Do not throw away any left over tablets. Instead, return them to your pharmacist so that they can be disposed of carefully. Only keep them if your doctor tells you to. |
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