Overdose symptoms may include severe nausea and vomiting. What should I avoid while using Tanzeum? Administration of stimulants may exacerbate symptoms of behavior disturbance and thought disorder in patients with a preexisting psychotic disorder. Norepinephrine Reuptake Inhibitors SNRIs May Result in Life-threatening Serotonin Syndrome. Another expert said the Hopkins findings weren't surprising. The same is true for nutritional counseling, whether the patient sees the family doctor or another health professional. venlafaxine
Patients should be advised that taking Celexa can cause mild pupillary dilation, which in susceptible individuals, can lead to an episode of angle closure glaucoma. Pre-existing glaucoma is almost always open-angle glaucoma because angle closure glaucoma, when diagnosed, can be treated definitively with iridectomy. Open-angle glaucoma is not a risk factor for angle closure glaucoma. The FDA requires all ADHD drugs to include patient medication guides that detail serious outcomes from the use of the drugs, including a slightly higher risk of stroke, heart attack and sudden death, and psychiatric problems like becoming manic or psychotic.
I'm feeling anxious and worried pretty much all the time, but I notice it gets especially bad in the afternoons and evenings. The development of a potentially life-threatening serotonin syndrome or Neuroleptic Malignant Syndrome NMS-like reactions have been reported with SNRIs and SSRIs alone, including Citalopram treatment, but particularly with concomitant use of serotonergic drugs including triptans with drugs which impair metabolism of serotonin including MAOIs or with antipsychotics or other dopamine antagonists. Call the healthcare provider right away to report new or sudden changes in mood, behavior, thoughts, or feelings.
What Drugs Are Used To Treat Depression? Other possible side effects include drowsiness, poor concentration, and irritability. Nevertheless, plasma lithium levels should be monitored with appropriate adjustment to the lithium dose in accordance with standard clinical practice. Because lithium may enhance the serotonergic effects of citalopram, caution should be exercised when citalopram and lithium are coadministered. Two double-blind, placebo-controlled studies were conducted in 627 adults aged 18 to 65 years.
Although in controlled studies Celexa has not been shown to impair psychomotor performance, any psychoactive drug may impair judgment, thinking, or motor skills, so patients should be cautioned about operating hazardous machinery, including automobiles, until they are reasonably certain that Celexa therapy does not affect their ability to engage in such activities. Taking Prozac during pregnancy may cause serious lung problems or other complications in the baby. However, you may have a relapse of depression if you stop taking your antidepressant. Tell your doctor right away if you become pregnant. Do not start or stop taking this medicine during pregnancy without your doctor's advice. Take Celexa exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not use this medicine in larger or smaller amounts or for longer than recommended. How should I take mirtazapine? Celexa for 21 days did not affect the pharmacokinetics of warfarin, a CYP3A4 substrate. Prothrombin time was increased by 5%, the clinical significance of which is unknown. Celexa may be taken with or without food. Taking Prozac with other drugs that make you sleepy or slow your breathing can cause dangerous side effects or death. Ask your doctor before taking a sleeping pill, narcotic pain medicine, prescription cough medicine, a muscle relaxer, or medicine for anxiety, depression, or seizures. Changes in the electrical activity of your heart QT prolongation and Torsade de Pointes. Talk to your healthcare provider if you do not think that your condition is getting better with Celexa treatment. SIADH and was reversible when Celexa was discontinued. Do not use this medicine just before or after heart bypass surgery coronary artery bypass graft, or CABG.
Citalopram use is also not recommended in patients who are taking other drugs that prolong the QT interval. In more rare cases, observed symptoms included amnesia, confusion, coma, convulsions, hyperventilation, cyanosis, rhabdomyolysis, and ECG changes including QTc prolongation, nodal rhythm, ventricular arrhythmia, and very rare cases of torsade de pointes. Acute renal failure has been very rarely reported accompanying overdose. Do not use Wellbutrin if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others. Clinical experience with Celexa in patients with certain concomitant systemic illnesses is limited. Due to the risk of QT prolongation, citalopram use should be avoided in patients with certain cardiac conditions, and ECG monitoring is advised if Celexa must be used in such patients. Electrolytes should be monitored in treating patients with diseases or conditions that cause hypokalemia or hypomagnesemia. Because any psychoactive drug may impair judgment, thinking, or motor skills, however, patients should be cautioned about operating hazardous machinery, including automobiles, until they are reasonably certain that Celexa therapy does not affect their ability to engage in such activities. When treating a pregnant woman with Celexa, the physician should carefully consider both the potential risks of taking an SSRI, along with the established benefits of treating depression with an antidepressant. The concomitant use of Celexa with MAOIs intended to treat psychiatric disorders is contraindicated. Celexa should also not be started in a patient who is being treated with MAOIs such as linezolid or intravenous methylene blue. Do not use Prozac if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine. Serotonin release by platelets plays an important role in hemostasis. Epidemiological studies of the case-control and cohort design that have demonstrated an association between use of psychotropic drugs that interfere with serotonin reuptake and the occurrence of upper gastrointestinal bleeding have also shown that concurrent use of an NSAID or aspirin potentiated the risk of bleeding. Thus, patients should be cautioned about the use of such drugs concurrently with citalopram. As with the management of all overdosage, the possibility of multiple-drug ingestion should be considered. The physician may wish to consider contacting a poison control center for up-to-date information on the management of overdosage with methylphenidate. There are no adequately designed studies examining sexual dysfunction with citalopram treatment. Some young people have thoughts about suicide when first taking an antidepressant. Your doctor will need to check your progress at regular visits while you are using Wellbutrin. Your family or other caregivers should also be alert to changes in your mood or symptoms. It may take several weeks before your symptoms improve. Keep using Vraylar as directed and tell your doctor if your symptoms do not improve. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association, 1994. Among the two groups who had taken an SSRI, 33 took citalopram, 18 took escitalopram, 63 took fluoxetine, 2 took fluvoxamine, 78 took paroxetine, and 87 took sertraline. Among the women who took an SSRI, the breastfeeding rate at 2 weeks postpartum was 27% to 33% lower than mother who did not take antidepressants, with no statistical difference in breastfeeding rates between the SSRI-exposed groups. trihexyphenidyl
These drugs are provided at least in the beginning of medical therapy, but are not for long-term use. Bristol-Myers Squibb Company January, 2005. Safety and effectiveness in the pediatric population have not been established see BOX WARNING and WARNINGS - Clinical Worsening and Suicide Risk. Two placebo-controlled trials in 407 pediatric patients with MDD have been conducted with citalopram, and the data were not sufficient to support a claim for use in pediatric patients. Anyone considering the use of citalopram in a child or adolescent must balance the potential risks with the clinical need. Physicians are advised to discuss the following issues with patients for whom they prescribe citalopram. Art and music may help trigger memories and help people reconnect with the world around them. If your Dr suggests trying Lexapro or Effexor first. No reports involved the administration of methylene blue by other routes such as oral tablets or local tissue injection or at lower doses. There may be circumstances when it is necessary to initiate treatment with an MAOI such as linezolid or intravenous methylene blue in a patient taking Celexa. What Is the Treatment for Bulimia? The efficacy of citalopram in the treatment of depression was established in 4 to 6 week, controlled trials of outpatients whose diagnosis corresponded most closely to the DSM-III and DSM-III-R category of major depressive disorder see CLINICAL PHARMACOLOGY. Concomitant use in patients taking monoamine oxidase inhibitors MAOIs is contraindicated see WARNINGS. This drug has been associated with a dose-related QT-interval prolongation; there have been reports of QT-interval prolongation and ventricular arrhythmia, including torsade de pointes, particularly in females, patients with hypokalemia, or with pre-existing QT-interval prolongation, or other cardiac disease. Whether any of the symptoms described above represent such a conversion is unknown. However, prior to initiating treatment with an antidepressant, patients with depressive symptoms should be adequately screened to determine if they are at risk for bipolar disorder; such screening should include a detailed psychiatric history, including a family history of suicide, bipolar disorder, and depression. It should be noted that Celexa is not approved for use in treating bipolar depression. Your doctor may adjust the dose until it is right for you or your child. Hyponatremia may occur as a result of treatment with SSRIs and SNRIs, including citalopram. In many cases, this hyponatremia appears to be the result of the syndrome of inappropriate antidiuretic hormone secretion SIADH and was reversible when citalopram was discontinued. odlot.info eulexin
There are no adequate and well-controlled studies in pregnant women; therefore, citalopram should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. This medicine can cause you to have a false positive drug screening test. If you provide a urine sample for drug screening, tell the laboratory staff that you are taking buproban. Get emergency medical help if you have signs of an allergic reaction to citalopram: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Taking antipsychotic medicine in the last 3 months of pregnancy may cause problems in the newborn, such as withdrawal symptoms, breathing problems, feeding problems, fussiness, tremors, and limp or stiff muscles. However, you may have withdrawal symptoms or other problems if you stop taking your medicine during pregnancy. If you become pregnant, do not stop taking Vraylar without your doctor's advice. The Tanzeum prefilled injection pen comes in a strength of 30 milligrams mg or 50 mg. The pen contains powder medicine and a liquid that must be mixed before you give the injection. Each pen strength has a certain "wait" time to allow the powder to completely dissolve after mixing. The 30-mg pen needs 15 minutes of wait time, and the 50-mg pen needs 30 minutes of wait time. Mixed medicine must be used within 8 hours. The pupillary dilation that occurs following use of many antidepressant drugs including citalopram may trigger an angle closure attack in a patient with anatomically narrow angles who does not have a patent iridectomy. Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing. If desired, you may drink liquid to help swallow the dissolved tablet. buy cyproheptadine cheap online
Methotrexate sodium Inj. US prescribing information. It is estimated that over 30 million patients have been treated with citalopram since market introduction. Although no causal relationship to citalopram treatment has been found, the following adverse events have been reported to be temporally associated with citalopram treatment, and have not been described elsewhere in the labeling: acute renal failure, akathisia, allergic reaction, anaphylaxis, angioedema, choreoathetosis, chest pain, delirium, dyskinesia, ecchymosis, epidermal necrolysis, erythema multiforme, gastrointestinal hemorrhage, grand mal convulsions, hemolytic anemia, hepatic necrosis, myoclonus, neuroleptic malignant syndrome, nystagmus, pancreatitis, priapism, prolactinemia, prothrombin decreased, QT prolonged, rhabdomyolysis, serotonin syndrome, spontaneous abortion, thrombocytopenia, thrombosis, ventricular arrhythmia, torsades de pointes, and withdrawal syndrome. Published data are inadequate to determine whether chronic use of amphetamines may cause similar suppression of growth; however, it is anticipated that they likely have this effect as well. Therefore, growth should be monitored during treatment with stimulants, and patients who are not growing or gaining height or weight as expected may need to have their treatment interrupted. In 10 breastfed extent not stated infants aged 3 to 42 weeks whose mothers were taking citalopram in an average daily dosage of 24 mg range 20 to 50 mg citalopram was detected in 6 of the infants. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist. Serzone nefazodone hydrochloride US prescribing information. If you decide to stop taking your antidepressants, it is important that you gradually reduce the dose over a period of several weeks. Patients should be advised to notify their physician if they become pregnant or intend to become pregnant during therapy. Pharmaceuticals America, Inc. May, 2016. Additional studies to investigate the mechanism for this pathology have not been performed, and the potential significance of this effect in humans has not been established. Post the schedule in a central place, such as the kitchen or main hallway of your house. This information should not be used to decide whether or not to take desipramine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about desipramine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to desipramine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using desipramine. The orally disintegrating tablet may contain phenylalanine. Talk to your doctor before using this form of mirtazapine if you have phenylketonuria PKU. Comments: The day of weekly administration may be changed if necessary as long as the last dose was administered 4 or more days before.
Prozac fluoxetine hydrochloride US prescribing information. They only have to show, usually in a small number of healthy volunteers, that their drugs deliver the same active ingredients in the same way as brand-name drugs. These changes, known as prolongation of the QT interval, can lead to fatal changes in the heart's rhythm. Dose increases should usually occur in increments of 20 mg at intervals of no less than one week. Disclaimer: Every effort has been made to ensure that the information provided by Multum, Truven Health Analytics, Inc. This is a movement disorder that results in unusual and uncontrollable movements, usually of the tongue and face such as sticking out the tongue and smacking the lips and sometimes jerking and twisting movements of other parts of the body. How should I take citalopram? It is not known whether Imitrex will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant. HAPPY, and feeling NORMAL again. The first couple of days my stomach was a little upset but once I drank a lot of fluids with the medication I have not had a problem. BOM strain mice and COBS WI strain rats for 18 and 24 months, respectively. ADHD that may include other measures psychological, educational, social. Drug treatment may not be indicated for all patients with ADHD. Consideration should be given to changing the therapeutic regimen, including possibly discontinuing the medication, in patients whose depression is persistently worse, or who are experiencing emergent suicidality or symptoms that might be precursors to worsening depression or suicidality, especially if these symptoms are severe, abrupt in onset, or were not part of the patient's presenting symptoms. Do not stop using Wellbutrin suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine. Taking Vraylar 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. buy cheapest ursofalk visa uk
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. Prescriptions for Citalopram Tablets should be written for the smallest quantity of tablets consistent with good patient management, in order to reduce the risk of overdose. Trust me, if you are sensitive to medications in general, especially AntiDepressants, Celexa may work for you. I pray that someone reads this and find it helpful! Luvox fluvoxamine maleate US prescribing information. It is generally agreed that acute episodes of depression require several months or longer of sustained pharmacologic therapy. Systematic evaluation of Celexa in two studies has shown that its antidepressant efficacy is maintained for periods of up to 24 weeks following 6 or 8 weeks of initial treatment 32 weeks total. Tell your doctor if you or your child has any heart problems, heart defects, high blood pressure, or a family history of these problems. Some patients may prove resistant to all discontinuation regimens. At an alcohol concentration up to 40% there was no increased release of methylphenidate in the first hour. The results with the 18 mg tablet strength are considered representative of the other available tablet strengths. Pink, oval, scored, film-coated. Get emergency medical help if you have signs of an allergic reaction to Celexa: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat. After using one nasal capsule in each nostril: If your headache does not completely go away, or goes away and comes back, you may use a second dose 1 capsule per nostril if it has been at least two hours since you used the first capsules. Do not use more than two doses 4 nosepieces in 24 hours. If your symptoms do not improve, contact your doctor before using any more Imitrex nasal capsules. enalapril order now online payment
You may take Vraylar with or without food. Celexa and placebo groups were compared with respect to 1 mean change from baseline in vital signs pulse, systolic blood pressure, and diastolic blood pressure and 2 the incidence of patients meeting criteria for potentially clinically significant changes from baseline in these variables. These analyses did not reveal any clinically important changes in vital signs associated with Celexa treatment. In addition, a comparison of supine and standing vital sign measures for Celexa and placebo treatments indicated that Celexa treatment is not associated with orthostatic changes. This list is not complete and many other drugs can interact with citalopram. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you. Diabetes patients - Desipramine may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine. After you start using desipramine, several weeks may pass before you feel the full benefit. The information on this page is not a substitute for the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that a drug or drug combination is safe, effective or appropriate for any given patient. Drugs. All reported events are included except those already listed in or elsewhere in labeling, those events for which a drug cause was remote, those event terms which were so general as to be uninformative, and those occurring in only one patient. Savella milnacipran hydrochloride US prescribing information. Forest Pharmaceuticals, Inc. October, 2013. carbimazole
Clinical Worsening and Suicide Risk. Two placebo-controlled trials in 407 pediatric patients with MDD have been conducted with citalopram, and the data were not sufficient to support a claim for use in pediatric patients. Anyone considering the use of citalopram in a child or adolescent must balance the potential risks with the clinical need. Drinking alcohol with bupropion may increase your risk of seizures. If you drink alcohol regularly, talk with your doctor before changing the amount you drink. Bupropion can also cause seizures in people who drink a lot of alcohol and then suddenly quit drinking when they start using the medication. In some cases, a patient already receiving Celexa therapy may require urgent treatment with linezolid or intravenous methylene blue. If acceptable alternatives to linezolid or intravenous methylene blue treatment are not available and the potential benefits of linezolid or intravenous methylene blue treatment are judged to outweigh the risks of serotonin syndrome in a particular patient, Celexa should be stopped promptly, and linezolid or intravenous methylene blue can be administered. The patient should be monitored for symptoms of serotonin syndrome for 2 weeks or until 24 hours after the last dose of linezolid or intravenous methylene blue, whichever comes first. Instruct patients to report to their physician any new numbness, pain, skin color change, or sensitivity to temperature in fingers or toes. Although in controlled studies citalopram has not been shown to impair psychomotor performance, any psychoactive drug may impair judgment, thinking or motor skills, so patients should be cautioned about operating hazardous machinery, including automobiles, until they are reasonably certain that citalopram therapy does not affect their ability to engage in such activities. DDCT levels rarely exceeded 70 nM; the highest measured level of DDCT in human overdose was 138 nM. While DDCT is ordinarily present in humans at lower levels than in dogs, it is unknown whether there are individuals who may achieve higher DDCT levels. The possibility that DCT, a principal metabolite in humans, may prolong the QT interval in dogs has not been directly examined because DCT is rapidly converted to DDCT in that species. Celexa and placebo groups were compared with respect to 1 mean change from baseline in various serum chemistry, hematology, and urinalysis variables, and 2 the incidence of patients meeting criteria for potentially clinically significant changes from baseline in these variables. These analyses revealed no clinically important changes in laboratory test parameters associated with Celexa treatment. As a side note, I am also someone who eats very healthy, works out daily and has a lot of family support. Thus, I hope that I will be able to be on Celexa long enough to dig out of what I like to call my depression, "the black hole". Exclusivity is the sole marketing rights granted by the FDA to a manufacturer upon the approval of a drug and may run simultaneously with a patent. Exclusivity periods can run from 180 days to seven years depending upon the circumstance of the exclusivity grant. Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, depression, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive mentally or physically or have thoughts about suicide or hurting yourself. There are no specific laboratory tests recommended.
Celexa for 22 days resulted in a two-fold increase in the plasma levels of the beta-adrenergic blocker metoprolol. Increased metoprolol plasma levels have been associated with decreased cardioselectivity. Coadministration of Celexa and metoprolol had no clinically significant effects on blood pressure or heart rate. Tahir N. Serotonin syndrome as a consequence of drug-resistant infections: an interaction between linezolid and citalopram. Physicians should also note the results of a prospective longitudinal study of 201 pregnant women with a history of major depression, who were either on antidepressants or had received antidepressants less than 12 weeks prior to their last menstrual period, and were in remission. Women who discontinued antidepressant medication during pregnancy showed a significant increase in relapse of their major depression compared to those women who remained on antidepressant medication throughout pregnancy. Distributed by: Allergan USA, Inc. If you are scheduled for surgery, inform your doctor or the anesthesiologist that you are taking this medication. This warning includes oral surgery. Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. Citalopram is not recommended for use at doses greater than 40 mg per day because such doses cause too large an effect on the QT interval and confer no additional benefit. There are so many SSRI and SSNRI antidepressants available now. The older medications Zoloft, Prozac and Celexa now have generic alternatives, which are equally effective and much cheaper. Citalopram is contraindicated in patients with a hypersensitivity to citalopram or any of the inactive ingredients in citalopram hydrobromide capsules. buy zebeta visa canada
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Patients should be advised of the following issues and asked to alert their prescriber if these occur while taking Citalopram Tablets. The prolactin level in a mother with established lactation may not affect her ability to breastfeed. Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Imitrex only for the indication prescribed.
Periodic CBC, differential, and platelet counts are advised during prolonged therapy. Read the Medication Guide that comes with Celexa before you start taking it and each time you get a refill. There may be new information. This Medication Guide does not take the place of talking to your healthcare provider about your medical condition or treatment. Talk with your healthcare provider if there is something you do not understand or want to learn more about. Joffe RT, Sokolov ST. Co-administration of fluoxetine and sumatriptan: the Canadian experience. Treatment should be started at the first sign of a migraine headache, or associated symptoms such as nausea, vomiting, or photophobia; this drug should not be used for migraine prophylaxis.
The effect of citalopram on labor and delivery in humans is unknown. Some of the side effects that can occur with citalopram may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. Check with your doctor before you drink alcohol or use medicines that may cause drowsiness eg, sleep aids, muscle relaxers while you are using desipramine; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
Audience: Neuropsychiatric healthcare professionals and consumersThe FDA asked manufacturers of the following antidepressant drugs to include in their labeling a Warning statement that recommends close observation of adult and pediatric patients for worsening depression or the emergence of suicidality when treated with these agents. The drugs that are the focus of this new Warning are: Prozac fluoxetine; Zoloft sertraline; Paxil paroxetine; Luvox fluvoxamine; Celexa citalopram; Lexapro escitalopram; Wellbutrin bupropion; Effexor venlafaxine; Serzone nefazodone; and Remeron mirtazapine. It is estimated that over 30 million patients have been treated with Celexa since market introduction. Although no causal relationship to Celexa treatment has been found, the following adverse events have been reported to be temporally associated with Celexa treatment, and have not been described elsewhere in labeling: acute renal failure, akathisia, allergic reaction, anaphylaxis, angioedema, choreoathetosis, chest pain, delirium, dyskinesia, ecchymosis, epidermal necrolysis, erythema multiforme, gastrointestinal hemorrhage, angle closure glaucoma, grand mal convulsions, hemolytic anemia, hepatic necrosis, myoclonus, nystagmus, pancreatitis, priapism, prolactinemia, prothrombin decreased, QT prolonged, rhabdomyolysis, spontaneous abortion, thrombocytopenia, thrombosis, ventricular arrhythmia, torsade de pointes, and withdrawal syndrome.