Do not take this medication with any of the following:
-Cidofovir
-Ergot alkaloids, such as dihydroergotamine, ergotamine, methylergonovine
-Ketorolac
-MAOIs, such as Marplan, Nardil, Parnate
-Propranolol
This medication may also interact with the following:
-Alcohol
-Aspirin and aspirin-like medications
-Blood thinners
-Cyclosporine
-Digoxin
-Diuretics
-Lithium
-Medications for blood pressure
-Methotrexate
-Other NSAIDS, medications for pain and inflammation, such as ibuprofen and naproxen
-Some medications for depression
-Steroid medications, such as prednisone or cortisone
-Supplements, such as garlic, ginger, ginkgo, methylsulfonylmethane (MSM)
Other medications may affect the way this medication works. Talk with your care team about all the medications you take. They may suggest changes to your treatment plan to lower the risk of side effects and to make sure your medications work as intended.
This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.
Visit your care team for regular checks on your progress. Tell your care team if your symptoms do not start to get better or if they get worse.
Do not take aspirin or other NSAIDs, such as ibuprofen or naproxen, while you are taking this medication. Side effects, such as upset stomach, nausea, and ulcers, may be more likely to occur. Many over-the-counter medications contain aspirin, ibuprofen, or naproxen. It is important to read labels carefully. Talk to your care team about all the medications you take. They can tell you what is safe to take together.
This medication can cause serious bleeding, ulcers, or tears in the stomach. These problems can occur at any time and with no warning signs. They are more common with long-term use. Talk to your care team right away if you have stomach pain, bloody or black, tar-like stools, or vomit blood that is red or looks like coffee grounds.
This medication increases the risk of blood clots, heart attack, and stroke. These events can occur at any time. They are more common with long-term use and in those who have heart disease. If you take aspirin to prevent a heart attack or stroke, talk to your care team. They can help you find an option that works for you.
This medication may cause serious skin reactions. They can happen weeks to months after starting the medication. Talk to your care team right away if you have fevers or flu-like symptoms with a rash. The rash may be red or purple and then turn into blisters or peeling of the skin. Or you might notice a red rash with swelling of the face, lips, or lymph nodes in your neck or under your arms.
This medication may affect your coordination, reaction time, or judgment. Do not drive or operate machinery until you know how this medication affects you. Sit up or stand slowly to reduce the risk of dizzy or fainting spells. Drinking alcohol with this medication can increase the risk of these side effects.
If you take migraine medications for 10 or more days a month, your migraines may get worse. Keep a diary of headache days and medication use. Contact your care team if your migraine attacks occur more frequently.
Tell your care team right away if you notice unexplained wounds on your fingers or toes while taking this medication. You should also tell your care team if you experience numbness or pain, changes in the skin color, or sensitivity to temperature in your fingers or toes.
Talk to your care team if you may be pregnant. Taking this medication after 20 weeks of pregnancy may cause serious birth defects. Use of this medication after 30 weeks of pregnancy is not recommended.
This medication may cause infertility. It is usually temporary. Talk to your care team if you are concerned about your fertility.
Side effects that you should report to your care team as soon as possible:
-Allergic reactions or angioedema—skin rash, itching or hives, swelling of the face, eyes, lips, tongue, arms, or legs, trouble swallowing or breathing
-Bleeding—bloody or black, tar-like stools, vomiting blood or brown material that looks like coffee grounds, red or dark brown urine, small red or purple spots on skin, unusual bruising or bleeding
-Burning, pain, tingling, or color changes in the hands, arms, legs, or feet
-Heart attack—pain or tightness in the chest, shoulders, arms, or jaw, nausea, shortness of breath, cold or clammy skin, feeling faint or lightheaded
-Heart failure—shortness of breath, swelling of the ankles, feet, or hands, sudden weight gain, unusual weakness or fatigue
-Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing
-High potassium level—muscle weakness, fast or irregular heartbeat
-Increase in blood pressure
-Irritability, confusion, fast or irregular heartbeat, muscle stiffness, twitching muscles, sweating, high fever, seizure, chills, vomiting, diarrhea, which may be signs of serotonin syndrome
-Kidney injury—decrease in the amount of urine, swelling of the ankles, hands, or feet
-Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
-Low red blood cell level—unusual weakness or fatigue, dizziness, headache, trouble breathing
-Rash, fever, and swollen lymph nodes
-Raynaud syndrome—cool, numb, or painful fingers or toes that may change color from pale, to blue, to red
-Redness, blistering, peeling, or loosening of the skin, including inside the mouth
-Round red or dark patches on the skin that may itch, burn, and blister
-Stroke—sudden numbness or weakness of the face, arm, or leg, trouble speaking, confusion, trouble walking, loss of balance or coordination, dizziness, severe headache, change in vision
-Sudden or severe stomach pain, bloody diarrhea, fever, nausea, vomiting
-Vision loss
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
-Dizziness
-Fatigue
-Headache
-Loss of appetite
-Nausea
-Upset stomach
This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
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