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→Adverse Effects
'''Caution should be taken in if the animal suffers from any of the following pre-existing medical conditions:'''
'''Caution should be taken in if the animal suffers from any of the following pre-existing medical conditions:'''
*Heart disease, especially heart block and arrythmias.
*Heart disease, especially heart block and arrythmias
*Diabetes: increases hyperglycaemia.
*Diabetes: increases hyperglycaemia
*Glaucoma [closed angle type].
*Glaucoma [closed angle type]
*Impaired liver function [TCAs metabolised by liver]
*Impaired liver function [TCAs metabolised by liver]
*Hyperthyroidism [enhanced response to TCAs]
*Hyperthyroidism [enhanced response to TCAs]
'''Care should be taken if used in conjunction with any of the following drugs, which may interact and cause adverse effects:'''
'''Care should be taken if used in conjunction with any of the following drugs, which may interact and cause adverse effects:'''
*Morphine: enhanced analgesia and respiratory depression
*Morphine: enhanced analgesia and respiratory depression.
*MAOIs: risk of serotonin syndrome, advise washout period of 2-3 weeks between treatment with these drugs.
*MAOIs: risk of serotonin syndrome, advise washout period of 2-3 weeks between treatment with these drugs.
*Phenothiazines: increased shared adverse effects [CVS, etc], mutual increase in serum levels due to competition for cytochrome p450. Definite risk of severe adverse affects and toxicity.
*Phenothiazines: increased shared adverse effects [CVS, etc], mutual increase in serum levels due to competition for cytochrome p450. Definite risk of severe adverse affects and toxicity.
*SSRIs: Fluoxetine inhibits Cytochrome p450, leading to toxic levels of TCA.
*SSRIs: Fluoxetine inhibits Cytochrome p450, leading to toxic levels of TCA. Cimetidine also has this effect.
*Fibre rich diets reduce availability of TCAs.
*Fibre rich diets reduce availability of TCAs.
*Head pain
*Head pain
*Agitation
*Agitation
*Increased heart rate, body temperature, respiratory rate.
*Increased heart rate, body temperature, respiratory rate
*Muscular rigidity
*Muscular rigidity
*Convulsions
*Convulsions