Use w/ caution when co-administered w/ other centrally acting drugs; CYP2D6 substrates w/ a narrow therapeutic index. Increased C
max & AUC w/ cimetidine. Potential decrease in clearance w/ potent CYP3A4 inhibitor (eg, ketoconazole, itraconazole, fluconazole, erythromycin) or potent CYP2C19 inhibitor (eg, omeprazole, esomeprazole, fluvoxamine, lansoprazole, ticlopidine). Increased risk of bleeding w/ NSAID, aspirin, warfarin or other anticoagulants. Additive effect on QT interval w/ pimozide, drugs known to prolong the QT/QTc interval or drugs that can disrupt electrolyte levels. Increased risk of serotonin syndrome or neuroleptic malignant syndrome w/ MAOIs & other serotonergic drugs (eg, tryptophan, triptans, serotonin reuptake inhibitors, lithium, St. John's Wort, fentanyl & its analogues, dextromethorphan, tramadol, tapentadol, meperidine, methadone, pentazocine). Avoid concomitant use of alcohol. Do not take together w/ escitalopram.