Avoid abrupt discontinuation. Not for use in opioid-dependent patients. Seizure risk used alone or in concomitant use w/ SSRI, TCAs & other tricyclic compds or other opioids, MAOI, neuroleptics or other drugs that lower seizure threshold. Risk of convulsion in patients w/ epilepsy, history of seizures, risk of seizure (eg, head trauma, metabolic disorders, alcohol & drug w/drawal, CNS infections). Patients at risk of resp depression, known CYP2D6 ultra-rapid metabolizers. Patients receiving CNS depressants (eg, alcohol, opioids, anesth, narcotics, phenothiazines, tranquilizers or sedatives) increase risk of CNS & resp depression. Increased ICP or head trauma. May impair mental or physical abilities for performance of hazardous tasks eg, driving a car or operating machinery. Pregnancy. Not recommended in breastfeeding women.
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