The following conditions are contraindicated with this drug. Check with your physician if you have any of the following:


  • caloric undernutrition
  • acute liver failure
  • liver problems
  • a condition where the body is unable to maintain adequate blood flow called shock
  • acetaminophen overdose
  • acute inflammation of the liver due to hepatitis C virus
  • low blood sugar
  • decreased function of the adrenal gland
  • low amount of sodium in the blood
  • symptoms from alcohol withdrawal
  • suicidal behavior
  • suicidal thoughts
  • alcoholism
  • alcohol intoxication
  • drug abuse
  • depression
  • serotonin syndrome, a type of disorder with high serotonin levels
  • a low seizure threshold
  • asthma
  • decreased lung function
  • blockage of the stomach or intestine
  • hardening of the liver
  • seizures
  • opioid overdose
  • a patient who is producing milk and breastfeeding
  • benzodiazepine overdose
  • high pressure within the skull
  • nervous system infection of brain and spinal cord
  • inherited dysfunction of autonomic nerve function
  • chronic obstructive pulmonary disease
  • CYP2D6 ultrarapid metabolizer
  • CYP2D6 poor metabolizer
  • sleep apnea due to airway obstruction
  • surgical removal of the adenoids in pediatric patient
  • surgical removal of the tonsils in pediatric patient
  • chronic kidney disease stage 4 (severe)
  • chronic kidney disease stage 5 (failure)
  • chronic kidney disease stage 5 (failure) without dialysis GFR<15 mL/min

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Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.