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===Interactions===
 
===Interactions===
 
'''Care should be taken if used in conjunction with any of the following drugs, which may interact and cause severe adverse effects:'''
 
'''Care should be taken if used in conjunction with any of the following drugs, which may interact and cause severe adverse effects:'''
*Opioids (e.g. morphine): enhanced analgesia and respiratory depression.
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*'''Opioids''' (e.g. morphine): enhanced analgesia and respiratory depression.
*MAOIs: risk of serotonin syndrome, advise washout period of 2-3 weeks between treatment with these drugs<ref>Brown, T.M., Skop, B.P., Mareth, T.R., 1996. Pathophysiology and management of the serotonin syndrome. The Annals of Pharmacotherapy 30, 527–533.</ref>.
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*'''MAOIs''': risk of serotonin syndrome, advise washout period of 2-3 weeks between treatment with these drugs<ref>Brown, T.M., Skop, B.P., Mareth, T.R., 1996. Pathophysiology and management of the serotonin syndrome. The Annals of Pharmacotherapy 30, 527–533.</ref>.
*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.
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*'''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.
*Thyroid medications: if used simultaneously patients must be carefully monitored <ref>Gullikers, K.P., Panciera, D.L., 2002. Influence of various medications on canine thyroid function. Compendium of Continuing Education for the Practicing Veterinarian 24, 511-521</ref>
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*'''Thyroid medications''': if used simultaneously patients must be carefully monitored <ref>Gullikers, K.P., Panciera, D.L., 2002. Influence of various medications on canine thyroid function. Compendium of Continuing Education for the Practicing Veterinarian 24, 511-521</ref>
 
*Inhibitors of cytochrome p450, including other SSRI drugs, ketoconazole and cimetidine.  
 
*Inhibitors of cytochrome p450, including other SSRI drugs, ketoconazole and cimetidine.  
 
*Drugs which lower seizure threshold (eg. phenothiazines such as acepromazine or chlorpromazine).
 
*Drugs which lower seizure threshold (eg. phenothiazines such as acepromazine or chlorpromazine).

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