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Whether these systemic reactions and rash have a common underlying cause or are due to different etiologies or pathogenic processes is not knownFurthermorea specific underlying immunologic basis for these reactions has not been identifiedUpon the appearance of rash or of other possibly allergic phenomena for which an alternative etiology cannot be identifiedSARAFEM should be discontinued.

Patientstheir familiesand their caregivers should be encouraged to be alert to the emergence of anxietyagitationpanic attacksinsomniairritabilityhostilityaggressivenessimpulsivityakathisiapsychomotor restlessnesshypomaniamaniaother unusual changes in behaviorworsening of depressionand suicidal ideationespecially early during antidepressant treatment and when the dose is adjusted up or downFamilies and caregivers of patients should be advised to look for the emergence of such symptoms on a day-to-day basissince changes may be abruptSuch symptoms should be reported to the patient’s prescriber or health professionalespecially if they are severeabrupt in onsetor were not part of the patient’s presenting symptomsSymptoms such as these may be associated with an increased risk for suicidal thinking and behavior and indicate a need for very close monitoring and possibly changes in the medicationsee BOXED WARNING and WARNINGS AND PRECAUTIONS

Drug interactions may change how your medications work or increase your risk for serious side effectsThis document does not contain all possible drug interactionsKeep a list of all the products you useincluding prescription/nonprescription drugs and herbal productsand share it with your doctor and pharmacistDo not startstopor change the dosage of any medicines without your doctor’s approval.

This drug may make you dizzy or drowsyAlcohol or marijuana can make you more dizzy or drowsyDo not driveuse machineryor do anything that needs alertness until you can do it safelyAvoid alcoholic beveragesTalk to your doctor if you are using marijuana.

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