FDA. Novartis Animal Health US, Inc. Nervous System: Frequent: abnormal thinking, vertigo. Infrequent: abnormal coordination, abnormal EEG, abnormal gait, apathy, ataxia, coma, convulsions, delirium, delusion, dyskinesia, dysphonia, encephalopathy, euphoria, extrapyramidal disorder, hallucinations, hostility, hyperkinesia, hypnagogic hallucinations, hypokinesia, leg cramps, manic reaction, neuralgia, paranoia, phobic disorder, psychosis, sensory disturbance, somnambulism, stimulation, suicidal ideation, suicide attempt, teeth-grinding. Rare: anticholinergic syndrome, aphasia, apraxia, catalepsy, cholinergic syndrome, choreoathetosis, generalized spasm, hemiparesis, hyperesthesia, hyperreflexia, hypoesthesia, illusion, impaired impulse control, indecisiveness, mutism, neuropathy, nystagmus, oculogyric crisis, oculomotor nerve paralysis, schizophrenic reaction, stupor, suicide. purchase stromectol shopping usa
Serum concentrations were not found to correlate to withdrawal symptoms ter Horst 2011. Withdrawal symptoms including jitteriness, tremor, and seizures have been observed in neonates whose mothers took clomipramine up to delivery. Once the desired clinical effect is achieved and the owners have successfully instituted the appropriate behavioral modification, the dose of Clomicalm Tablets may be reduced to maintain the desired effect or discontinued. Withdrawal side effects were not reported in studies with Clomicalm Tablets in dogs. Not for use in humans. KEEP OUT OF REACH OF CHILDREN. In case of accidental ingestion seek medical attention im mediately. In children, accidental ingestion should be regard ed as serious. There is no specific antidote for clomipramine.
Intermezzo R should be taken in bed when a patient wakes in the middle of the night and has difficulty returning to sleep. Place under the tongue and allow to disintegrate completely before swallowing. The tablet should not be swallowed whole and not administered with or immediately after a meal. Use this medication regularly in order to get the most benefit from it. Continue to take it even if you feel well. To help you remember, use it at the same times each day. You can make a meaningful difference with these medicines. During premarket evaluation, seizure was identified as the most significant risk of clomipramine hydrochloride use.
The sedative effects of zolpidem may be stronger in older adults. Patients should notify their physician if they are breast-feeding. The most commonly observed adverse events associated with the use of clomipramine and not seen at an equivalent incidence among placebo-treated patients were gastrointestinal complaints, including dry mouth, constipation, nausea, dyspepsia, and anorexia; nervous system complaints, including somnolence, tremor, dizziness, nervousness, and myoclonus; genitourinary complaints, including changed libido, ejaculatory failure, impotence, and micturition disorder; and other miscellaneous complaints, including fatigue, sweating, increased appetite, weight gain, and visual changes.
Altretamine: May enhance the orthostatic hypotensive effect of Tricyclic Antidepressants. Hello I am a female 23 yrs old and was diagnosed with anxiety about 2 yrs ago. Mental status change such as confusion, delirium, mania, hypomania, agitation, coma, etc. Never take this medicine in larger amounts or for longer than prescribed. Discontinuation of therapy: Refer to adult dosing.
How do I get over my guilt? The concomitant use of clomipramine hydrochloride with MAOIs intended to treat psychiatric disorders is contraindicated. Clomipramine hydrochloride should also not be started in a patient who is being treated with MAOIs such as linezolid or intravenous methylene blue. Withdrawal symptoms have been reported in association with abrupt discontinuation of Anafranil. It is recommended that the dosage be tapered gradually and the patient monitored carefully during discontinuation. Clomipramine, sold under the brand name Anafranil among others, is a TCA. Although dose appears to be a predictor of seizure, there is a confounding of dose and duration of exposure, making it difficult to assess independently the effect of either factor alone. The ability to predict the occurrence of seizures in subjects exposed to doses of clomipramine greater than 250 mg is limited, given that the plasma concentration of clomipramine may be dose-dependent and may vary among subjects given the same dose. Store dextroamphetamine at room temperature, between 59 and 86 degrees F 15 and 30 degrees C. Store away from heat, moisture, and light. Keep in a tightly closed container. Do not store in the bathroom. Keep dextroamphetamine out of the reach of children and away from pets. The pupillary dilation that occurs following use of many antidepressant drugs including clomipramine hydrochloride may trigger an angle closure attack in a patient with anatomically narrow angles who does not have a patent iridectomy. Cannabis: May decrease the serum concentration of CYP1A2 Substrates. Spray Zolpimist directly into your mouth over your tongue. Prime the spray before the first use by pumping 5 test sprays into the air, away from your face. Prime the spray with 1 test spray if it has not been used for longer than 14 days. minomycin
Perhexiline: CYP2D6 Substrates may increase the serum concentration of Perhexiline. Perhexiline may increase the serum concentration of CYP2D6 Substrates. The use of MAOIs intended to treat psychiatric disorders with clomipramine hydrochloride or within 14 days of stopping treatment with clomipramine is contraindicated because of an increased risk of serotonin syndrome. NIMH-OC. Patients on placebo showed no important clinical response on either scale. The opinions expressed in WebMD User-generated content areas like communities, reviews, ratings, or blogs are solely those of the User, who may or may not have medical or scientific training. These opinions do not represent the opinions of WebMD. User-generated content areas are not reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other reason except for compliance with our Terms and Conditions. During initial titration, this drug should be given in divided doses with meals to reduce gastrointestinal side effects. Dose Establishment: A 12 week, placebo-controlled, multi-site clinical trial was conducted in the US and Europe to establish an effective dose of Clomicalm Tablets in dogs. Cyproterone: May decrease the serum concentration of CYP1A2 Substrates. Patients should be advised of the following issues and asked to alert their prescriber if these occur while taking clomipramine hydrochloride. buy propranolol doses propranolol
Secretin: Anticholinergic Agents may diminish the therapeutic effect of Secretin. Management: Avoid using drugs with substantial anticholinergic effects in patients receiving secretin whenever possible. If such agents must be used in combination, monitor closely for a diminished response to secretin. Orphenadrine: CNS Depressants may enhance the CNS depressant effect of Orphenadrine. CNS Depressants. Specifically, sleepiness and dizziness may be enhanced. Dextroamphetamine may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use dextroamphetamine with caution. PDF. TGA eBusiness Services. NOVARTIS Pharmaceuticals Australia Pty Limited. No. This is a warning about the risk for suicidality. Other side effects can occur with antidepressants. Be sure to ask your healthcare provider to explain all the side effects of the particular drug he or she is prescribing. Also ask about drugs to avoid when taking an antidepressant. Ask your healthcare provider or pharmacist where to find more information. Obinutuzumab: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Management: Consider temporarily withholding blood pressure lowering medications beginning 12 hours prior to obinutuzumab infusion and continuing until 1 hour after the end of the infusion. Prior to elective surgery with general anesthetics, therapy with clomipramine hydrochloride should be discontinued for as long as is clinically feasible, and the anesthetist should be advised. Levodopa: Blood Pressure Lowering Agents may enhance the hypotensive effect of Levodopa. CYP1A2 Inhibitors Moderate: May decrease the metabolism of CYP1A2 Substrates. CNS depressants is not recommended. The protein binding of clomipramine is approximately 97%, principally to albumin, and is independent of clomipramine concentration. Who should not take ClomiPRAMINE Hydrochloride Capsules? Palmer, NR; Stuckey, BG June 2008. PDF. The Medical Journal of Australia. buy topamax walmart
Hyperthermia has been reported in patients receiving Anafranil. Most cases were in combination with other drugs, including neuroleptic agents. General: Clomicalm Tablets are not recommended for other behavior problems, such as aggression see Adverse Reactions. Studies to establish the safety and efficacy of Clomicalm Tablets in dogs less than 6 months of age have not been conducted. To try to prevent suicidal thoughts and actions in your child, pay close attention to changes in her or his moods or actions, especially if the changes occur suddenly. The changes to look out for are listed in Section 3, on what to watch for. What is imipramine, and how does it work mechanism of action? Lab tests, including blood pressure and heart rate, may be performed while you use dextroamphetamine. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments. Wort is clinically warranted, patients should be made aware of a potential increased risk for serotonin syndrome, particularly during treatment initiation and dose increases. Lormetazepam: May enhance the hypotensive effect of Blood Pressure Lowering Agents. Zolpidem is not approved for use by anyone younger than 18 years old. If you'd like information on how to live with and manage your anxiety, then click to read more. Older adults may be more sensitive to the side effects of this drug, especially bleeding, confusion, dizziness, and QT prolongation see above. MAO inhibitor recommendations: Refer to adult dosing. Events reported by at least 1% of clomipramine patients are included. Dimethindene Topical: May enhance the CNS depressant effect of CNS Depressants. Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.
CYP1A2 Inhibitors Strong: May decrease the metabolism of CYP1A2 Substrates. For some people, the baggage that comes with ADHD is part of the problem. Squats, deadlifts, bench press, and military press. The ACOG recommends that therapy for depression during pregnancy be individualized; treatment should incorporate the clinical expertise of the mental health clinician, obstetrician, primary health care provider, and pediatrician ACOG 2008. According to the American Psychiatric Association APA the risks of medication treatment should be weighed against other treatment options and untreated depression. For women who discontinue antidepressant medications during pregnancy and who may be at high risk for postpartum depression, the medications can be restarted following delivery APA 2010. Treatment algorithms have been developed by the ACOG and the APA for the management of depression in women prior to conception and during pregnancy Yonkers 2009. Itopride: Anticholinergic Agents may diminish the therapeutic effect of Itopride. First, know you aren't alone -- there are many of us suffering depression, anxiety, awaking with panic and fearful thoughts and spinning mind, and finding no real "solutions" from psych consults, etc. No unusual age-related adverse events were identified in this population. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function and of concomitant disease or other drug therapy. ciprofloxacin generic brand name
Tricyclic Antidepressants. Management: Seek alternatives to this combination when possible. Monitor patients receiving metoclopramide with tricyclic antidepressants for signs of extrapyramidal symptoms, neuroleptic malignant syndrome, and serotonin syndrome. AST have occurred, including rare reports of severe hepatic injury some fatal; monitor hepatic transaminases periodically in patients with hepatic impairment. Continued behavioral modification is recommended to prevent recurrence of the clinical signs. Dosage adjustments should be made to maintain the patient on the lowest effective dosage. Retrieved 1 December 2013. Taking zolpidem with other drugs that make you sleepy or slow your breathing can cause dangerous or life-threatening side effects. Ask your doctor before taking a sleeping pill, narcotic pain medicine, prescription cough medicine, a muscle relaxer, or medicine for anxiety, depression, or seizures. NSAID Nonselective: Antidepressants Tricyclic, Tertiary Amine may enhance the antiplatelet effect of NSAID Nonselective. HYDROcodone: CNS Depressants may enhance the CNS depressant effect of HYDROcodone. Management: Avoid concomitant use of hydrocodone and benzodiazepines or other CNS depressants when possible. These agents should only be combined if alternative treatment options are inadequate. If combined, limit the dosages and duration of each drug. Should I Try Psychotherapy? There are no adequate or well-controlled studies in pregnant women. Withdrawal symptoms, including jitteriness, tremor, and seizures, have been reported in neonates whose mothers had taken clomipramine hydrochloride until delivery. Clomipramine hydrochloride should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose. What happens if I overdose? ADHD coaching, a new industry that offers very specific problem-solving, can also work for some people, Tzelepis says. The risks of using clomipramine in combination with other drugs have not been systematically evaluated. Given the primary CNS effects of clomipramine, caution is advised in using it concomitantly with other CNS-active drugs see PRECAUTIONS: Information for Patients. Take zolpidem exactly as prescribed by your doctor. Follow all directions on your prescription label. Never take zolpidem in larger amounts, or for longer than prescribed. Adults with ADHD and a family history of and should consider the effect of ADHD drugs, both stimulants and nonstimulants, although they are considered safe in the short term. It is unclear if it is safe for use in pregnancy. buy brand fludrocortisone canada fludrocortisone
What else do I need to know about antidepressant medicines? Keep all follow-up visits with the healthcare provider as scheduled. Call the healthcare provider between visits as needed, especially if you have concerns about symptoms. The specific methods of behavioral modification used in clinical trials involved desensitization and counterconditioning techniques. Since the manifestation of separation anxiety can vary according to the individual dog, it is advised that a specific behavior modification plan be developed based on a professional assessment of each individual case. Report any new or worsening symptoms to your doctor, such as: depression, anxiety, aggression, agitation, confusion, unusual thoughts, hallucinations, memory problems, changes in personality, risk-taking behavior, decreased inhibitions, no fear of danger, or thoughts of suicide or hurting yourself. Hey, i bet you had some minor attacks prior to the traffic incident but maybe didnt understand it was happening. Like you, i also have had my worse attacks in traffic, however, when i think back, I've always had some signs, walking into a classroom, going into crowded place or something, i would feel nervous and sweaty, the difference was there were others around to distract my mind, and you subconsciously know theres a way out, when your stuck in traffic with anxiety you always see the worse, theres no way out! The possibility of a suicide attempt is inherent in major depression and may persist until remission occurs. Worsening depression and severe abrupt suicidality that are not part of the presenting symptoms may require discontinuation or modification of drug therapy. Use caution in high-risk patients during initiation of therapy. DEFINITELY worry that I'm getting that! Families and caregivers of patients being treated with antidepressants for major depressive disorder or other indications, both psychiatric and nonpsychiatric, should be alerted about the need to monitor patients for the emergence of agitation, irritability, unusual changes in behavior, and the other symptoms described above, as well as the emergence of suicidality, and to report such symptoms immediately to health care providers. Such monitoring should include daily observation by families and caregivers. Richelson E, Nelson A July 1984. clamoxin
Dextroamphetamine is to be used only by the patient for whom it is prescribed. Do not share it with other people. After titration, the total daily dose may be given once a day at bedtime to minimize daytime sedation. Not all antidepressant medicines prescribed for children are FDA approved for use in children. Clomicalm Tablets are contraindicated for use in dogs with a history of seizures or concomitantly with drugs which lower the seizure threshold. Taylor, D; Paton, C; Shitij, K 2012. The 75 mg capsules are swedish orange opaque and flesh opaque imprinted on the cap and body with MYLAN over 3075 in black ink. The effectiveness of clomipramine for the treatment of OCD was demonstrated in multicenter, placebo-controlled, parallel-group studies, including two 10-week studies in adults and one 8-week study in children and adolescents 10 to 17 years of age. Patients in all studies had moderate-to-severe OCD DSM-III with mean baseline ratings on the Yale-Brown Obsessive Compulsive Scale YBOCS ranging from 26 to 28 and a mean baseline rating of 10 on the NIMH Clinical Global Obsessive Compulsive Scale NIMH-OC. Patients taking clomipramine experienced a mean reduction of approximately 10 on the YBOCS, representing an average improvement on this scale of 35% to 42% among adults and 37% among children and adolescents. Do not suddenly stop taking this medication without consulting your doctor. Some conditions may become worse when the drug is abruptly stopped. Dabrafenib: May decrease the serum concentration of CYP2C19 Substrates. Management: Seek alternatives to the CYP2C19 substrate when possible. If concomitant therapy cannot be avoided, monitor clinical effects of the substrate closely particularly therapeutic effects. Paraldehyde: CNS Depressants may enhance the CNS depressant effect of Paraldehyde. Retrieved Dec 2, 2015. Clomicalm Tablets are available in 5, 20, 40 and 80 mg tablet strengths in color-coded packaging for oral administration to dogs. It is important that your dog be closely monitored by your veterinarian while on a treatment plan with Clomicalm Tablets and behavior training. You must inform your veterinarian of any current or future medications you are administering to your dog. The use of Clomicalm Tablets in conjunction with certain other drugs or when your dog has other illnesses may be contraindicated or increase the risks of adverse reactions. MAOIs, including linezolid and intravenous methylene blue.
Patients treated with clomipramine have been reported to show a variety of neuropsychiatric signs and symptoms including delusions, hallucinations, psychotic episodes, confusion, and paranoia. Because of the uncontrolled nature of many of the studies, it is impossible to provide a precise estimate of the extent of risk imposed by treatment with clomipramine. As with tricyclic antidepressants to which it is closely related, clomipramine may precipitate an acute psychotic episode in patients with unrecognized schizophrenia. Clomipramine hydrochloride capsules are indicated for the treatment of obsessions and compulsions in patients with Obsessive-Compulsive Disorder OCD. The obsessions or compulsions must cause marked distress, be time-consuming, or significantly interfere with social or occupational functioning, in order to meet the DSM-III-R circa 1989 diagnosis of OCD. The most commonly reported side effects were somnolence, tremor, dizziness, headache, dry mouth, constipation, and nausea. It may take 2 to 3 weeks or longer before the full effects of this medication are noticed. Inform your doctor if your condition persists or if it worsens. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended. Prescribers or other health professionals should inform patients, their families, and their caregivers about the benefits and risks associated with treatment with clomipramine hydrochloride and should counsel them in its appropriate use. A patient Medication Guide about “Antidepressant Medicines, Depression and other Serious Mental Illness, and Suicidal Thoughts or Actions” is available for clomipramine hydrochloride. The prescriber or health professional should instruct patients, their families, and their caregivers to read the Medication Guide and should assist them in understanding its contents. Patients should be given the opportunity to discuss the contents of the Medication Guide and to obtain answers to any questions they may have. The complete text of the Medication Guide is reprinted at the end of this document. Allow 14 days to elapse between discontinuing an MAO inhibitor intended to treat psychiatric disorders and initiation of clomipramine. Mianserin: May enhance the anticholinergic effect of Anticholinergic Agents. Wolfe, RM. Aug 1997. "Antidepressant withdrawal reactions. Pay close attention to any changes, especially sudden changes, in mood, behaviors, thoughts, or feelings. This is very important when an antidepressant medicine is started or when the dose is changed. When used for long periods of time or at high doses, dextroamphetamine may not work as well and may require higher doses to obtain the same effect as when originally taken. This is known as TOLERANCE. Talk with your doctor if dextroamphetamine stops working well. Do not take more than prescribed. Never let your child stop taking an antidepressant without first talking to his or her healthcare provider. Stopping an antidepressant suddenly can cause other symptoms. But Adler says some patients may get better with ADHD medicine alone. You are never alone. We are here for you hugs. store levothyroxine cost
They can make a change in their life, unlearn bad habits, use their organizers well, plan better, listen better. If any of these are present, make sure you tell your healthcare provider before your child takes an antidepressant. Serious effects, including heart attack, stroke, and sudden death, have occurred with the use of stimulant medicines in patients with heart defects or other serious heart problems. If you have a heart defect or other serious heart problem, talk with your doctor about other therapies to treat your condition. Serious adverse reactions may include clinical worsening of depression and suicidal ideation; seizures; serotonin syndrome; neuropsychiatric signs and symptoms including delusions, hallucinations, psychotic episodes, confusion, and paranoia; precipitation of mania or hypomania; severe liver injury; hematologic changes including leukopenia, agranulocytosis, thrombocytopenia, anemia, and pancytopenia; and hyperthermia. OnabotulinumtoxinA: Anticholinergic Agents may enhance the anticholinergic effect of OnabotulinumtoxinA. The 25 mg capsules are medium orange opaque and flesh opaque imprinted on the cap and body with MYLAN over 3025 in black ink. If ADHD seems to be the patient's primary disorder, Tzelepis says she'll help a patient focus on "executive functions" including time management and planning. Digestive System: Infrequent: abnormal hepatic function, blood in stool, colitis, duodenitis, gastric ulcer, gastritis, gastroesophageal reflux, gingivitis, glossitis, hemorrhoids, hepatitis, increased saliva, irritable bowel syndrome, peptic ulcer, rectal hemorrhage, tongue ulceration, tooth caries. Dextroamphetamine comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get dextroamphetamine refilled. Patients with significantly impaired renal function. uvik.info effexor
Endocrine System: Infrequent: hypothyroidism. Rare: goiter, gynecomastia, hyperthyroidism. NSAID COX-2 Inhibitor: Antidepressants Tricyclic, Tertiary Amine may enhance the antiplatelet effect of NSAID COX-2 Inhibitor. This drug is available at a middle level co-pay. Use with caution in patients with significantly impaired renal function. Coauthor Leslie Roach said, "Even though I do think yoga is, in general, incredibly beneficial, I also think there needs to be a whole lot more education about how to use yoga specifically to treat survivors of trauma in order to be the most effective and helpful. So as a standalone treatment right now, it's just not viable. It may be prudent to initiate treatment in divided doses to minimize side effects by permitting tolerance to side effects to develop or allowing the patient time to adapt if tolerance does not develop. To reduce the incidence of vomiting that may be experienced by some dogs, Clomicalm Tablets may be given with a small amount of food. The prescriber should be aware that these figures cannot be used to predict the incidence of side effects in the course of usual medical practice, in which patient characteristics and other factors differ from those that prevailed in the clinical trials. Similarly, the cited frequencies cannot be compared with figures obtained from other clinical investigations involving different treatments, uses, and investigators. The cited figures, however, provide the physician with a basis for estimating the relative contribution of drug and nondrug factors to the incidence of side effects in the populations studied. Do not take this medicine if you have consumed alcohol during the day or just before bed. Citalopram. Tricyclic Antidepressants may increase the serum concentration of Citalopram. Citalopram may increase the serum concentration of Tricyclic Antidepressants. Management: Consider alternatives to this combination when possible. Monitor for adverse effects of tricyclic antidepressants TCAs including serotonin syndrome and QT-interval prolongation, when a TCA is being used in combination with citalopram. terbinafine
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If any of these effects persist or worsen, notify your doctor or promptly. Tetrahydrocannabinol: May enhance the CNS depressant effect of CNS Depressants. The 50 mg capsules are yellow opaque and flesh opaque imprinted on the cap and body with MYLAN over 3050 in black ink. Insomnia symptoms may also return after you stop taking zolpidem. These symptoms may seem to be even worse than before you started taking the medicine. Call your doctor if you still have worsened insomnia after the first few nights without taking zolpidem. NEVER AGAIN. My Mom is now the same age that he was when he died so I think about how I'm going to handle it or I should say NOT handle it when she dies.
Discontinuation syndrome: Abrupt discontinuation or interruption of antidepressant therapy has been associated with a discontinuation syndrome. Symptoms arising may vary with antidepressant however commonly include nausea, vomiting, diarrhea, headaches, light-headedness, dizziness, diminished appetite, sweating, chills, tremors, paresthesias, fatigue, somnolence, and sleep disturbances eg, vivid dreams, insomnia. Less common symptoms include electric shock-like sensations, cardiac arrhythmias more common with tricyclic antidepressants myalgias, parkinsonism, arthralgias, and balance difficulties.
Do not take an MAOI within 2 weeks of stopping clomipramine hydrochloride unless directed to do so by your physician. o Do not start clomipramine hydrochloride if you stopped taking an MAOI in the last 2 weeks unless directed to do so by your physician. Musculoskeletal System: Infrequent: arthrosis. Rare: dystonia, exostosis, lupus erythematosus rash, bruising, myopathy, myositis, polyarteritis nodosa, torticollis. DULoxetine: Blood Pressure Lowering Agents may enhance the hypotensive effect of DULoxetine.
Will I ever live a normal life again? Antidepressants are used to treat depression and other illnesses. Depression and other illnesses can lead to suicide. In some children and teenagers, treatment with an antidepressant increases suicidal thinking or actions. It is important to discuss all the risks of treating depression and also the risks of not treating it. You and your child should discuss all treatment choices with your healthcare provider, not just the use of antidepressants. Do not stop taking any medications without consulting your healthcare provider. Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. 'Multum' is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy.