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Nifedipine gel uk. M-29 is not a drug of abuse and is not dangerous when used as prescribed, but patients should be warned of the possible increased risk fatal drug interactions and suicide attempts associated with the use of this drug alone and in combination with alcohol, antidepressants, or other drugs. M-29 should be used with extreme caution in patients who are dependent on prescription and/or over-the-counter medications, particularly when combined with other drugs that can cause interactions (see PRECAUTIONS: Drug Interactions: Drugs which cause clinically significant increases in blood concentrations). M-29 is not a drug of abuse and is not dangerous when used as prescribed; however, the potential benefits of treatment with M-29 should be weighed against the lack of safety when used alone and in combination with any prescribed drug. In clinical studies of patients with major depressive disorder, when coadministered with an antidepressant or antidepressant-like agent, the use of M-29 resulted in significant increases suicidal ideation, attempts, and completed suicide compared to a placebo (see RISKS: Psychiatric Events). If suicidal ideation, suicide attempts, or completions occur, treatment providers should carefully consider whether M-29 is safe to use. Clinical studies of treatment-naive patients with major depressive disorder using M-29 who met DSM-IV criteria for major depressive disorder did not show an effect on depressive symptoms (see Clinical Studies; STUDIES). In placebo-controlled trials patients with mood disorders without bipolar disorder, the percentage of patients who experienced antidepressant–induced mania was higher with M-29 compared to placebo. However, in clinical studies which subjects were at least 50 years old, M-29 was not more likely to be associated with manic episodes than placebo (see CLINICAL STUDIES). Adverse effects related to M-29 are mostly of a psychiatric nature. The most commonly reported adverse effect is sexual dysfunction in approximately 10% of users (see ADVERSE REACTIONS). The most frequent reactions associated with the use of M-29 in patients taking other antidepressants are somnolence and fatigue. The incidence of somnolence in M-29 group was about twice as high in placebo-treated patients (9.5% for M-29 vs 2.6% placebo). When used as an adjunct to other antidepressant treatments or in combination with antidepressants, M-29 is associated an increased incidence of serious side effects. These include akathisia, hypokalemia, hyperkalaemia, rhabdomyolysis, and rhabdomyolysis-like reactions. The safety of M-29 in patients with alcoholism has not been established. In the two placebo-controlled studies of patients with alcoholism, the incidence of serious adverse events was higher with M-29 (see WARNINGS AND PRECAUTIONS: Alcohol Side Effects). The following safety measures should be used whenever M-29 is during pregnancy: Avoid sexual intercourse and contraceptive oral contraceptives while M-29 is taken. Use M-29 only under the close supervision of a health professional. M-29 is contraindicated during pregnancy and lactation. The following medications can affect metabolism of M-29 and reduce its effectiveness: Amphetamine (dextroamphetamine sulfate, dextroamphetamine hydrochloride), and related salts, amphetamine, dextropropoxyphene, dextro-amphetamine, dextrorphan, dextrosulfan, dihydro-dextromethorphan (DMDP), dihydrodesoxymethylamphetamine (DES), dextroamphetamine sulphate, difepramide, trihexyphenidyl, tramadol, and other central nervous system depressants.

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