Nuedexta

Before taking this medicine

Do not take Nuedexta if you: - Are taking quinidine, quinine or mefloquine. - Have previously developed low platelet counts, hepatitis or another allergic reaction caused by quinidine, quinine or mefloquine, or have a known allergy to dextromethorphan. - Are taking a monoamine oxidase inhibitor (MAOI) or stopped one within the past 14 days. You must also wait 14 days after stopping Nuedexta before starting an MAOI. - Have a prolonged QT interval, congenital long QT syndrome, a history suggesting the abnormal heart rhythm torsades de pointes, or heart failure. - Have complete atrioventricular (AV) heart block without an implanted pacemaker, or are at high risk of complete AV block. - Take a medicine that both prolongs the QT interval and is broken down by CYP2D6, such as thioridazine or pimozide. ECG monitoring is needed if you have thickening or impaired function of the heart’s left ventricle, take a CYP3A4 inhibitor, or cannot avoid another medicine that prolongs the QT interval. Nuedexta can also affect the safety or effectiveness of medicines broken down by CYP2D6; your prescriber may need to adjust those medicines or choose an alternative. Taking Nuedexta with an SSRI or tricyclic antidepressant increases the risk of serotonin syndrome. Stop taking it if serotonin syndrome, low platelet counts, hepatitis or another allergic reaction occurs. Dizziness can occur, so take precautions to reduce falls. Myasthenia gravis and other conditions sensitive to quinidine’s anticholinergic effects require monitoring for worsening symptoms. During pregnancy, Nuedexta may harm the unborn baby, based on animal data.