- bloody/black/tarry stools
- vomit that looks like coffee grounds
- easy bruising/bleeding
- fainting
- fast/irregular heartbeat
- muscle weakness/spasm
- seizures
- change in 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 other SSRIs (e.g., citalopram, fluoxetine) and SNRIs (e.g., duloxetine, venlafaxine), lithium, tramadol, tryptophan, or a certain drug to treat obesity (sibutramine). 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
- unusual restlessness
- loss of coordination
- fast heartbeat
- severe dizziness
- unexplained fever
- severe nausea/vomiting/diarrhea
- twitchy muscles
For males, in the very unlikely event you have a painful or prolonged erection lasting 4 or more hours, stop using this drug and seek immediate medical attention, or permanent problems could occur.
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
- 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.
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