Common side effects

• Dyspepsia
• Constipation
• Pruritus of skin
• Drowsy
• Dizziness
• Insomnia
• Hyperhidrosis
• Diarrhea
• Nausea
• Vomiting
• Body fluid retention
• Tinnitus
• Flatulence
• Esophageal ulcer
• Peptic ulcer
• Gastrointestinal ulcer
• Skin rash
• Edema

If any of these effects persist or worsen, tell your doctor or pharmacist promptly

• Nausea
• Vomiting
• Constipation
• Diarrhea
• Dizziness
• Drowsiness

Tell your doctor right away if any of these unlikely but serious side effects occur

• Fainting
• Fast/pounding heartbeat
• Hearing changes
• Persistent/severe headache
• Vision changes
• Symptoms of heart failure

Tell your doctor right away if any of these rare but serious side effects occur

• Easy bruising/bleeding
• Signs of kidney problems

This drug may rarely cause serious liver disease. Get medical help right away if you have any symptoms of liver damage, including

• Dark urine
• Stomach/abdominal pain
• Persistent nausea/vomiting
• Yellowing eyes/skin

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including

• Rash
• Itching/swelling
• Severe dizziness
• Trouble breathing

Other things to note

• This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high.

• Before use, important to read the Medication Guide
• Watch for bleeding, heart attack or stroke signs.
• Avoid use in pregnancy from 20 weeks until birth
• May make you drowsy or dizzy. Drive with caution
• Limit alcohol consumption and stop using tobacco.
• Low dose daily aspirin ok Ask MD about other NSAIDs
• For powder in packet products : Mix drug in water and drink as directed. Call MD if new abdominal pain/yellowing eyes/skin.
• For tablet products : Best to take with food to lessen stomach upset. Take with 8 oz. liquid. Do not lie down for 10min.

• If you are pregnant or of childbearing age, discuss the risks/benefits of this medication with your doctor and pharmacist. ; Do not take aspirin products without doctor approval. Continue taking low-dose aspirin to prevent heart attack/stroke unless doctor tells you to stop. ; If you drink alcohol, discuss the safe use of alcohol while using this medication with your healthcare professional. ; May cause drowsiness and dizziness. Alcohol and marijuana may intensify this effect. Use care when operating a vehicle, vessel (e.g., boat), or machinery. ; May cause blurred vision ; Avoid prolonged or excessive exposure to direct and/or artificial sunlight while using this medication. ; For powder in packet products : This medication must be dissolved in water as directed before swallowing. ; For tablet products : May take with food to lessen chance of stomach upset. ; For tablet products : Do not lie down for at least 10 minutes after taking this medication. ; For tablet products : Medication should be taken with plenty of water. ;

Products that may interact with this drug include:

• Aliskiren
• ACE inhibitors (such as captopril, lisinopril)
• Angiotensin II receptor blockers (such as losartan, valsartan)
• Corticosteroids (such as prednisone)
• Lithium
• Methotrexate
• Other medications that may affect the kidneys (including cidofovir, water pills/diuretics such as furosemide)