Adverse Reactions and Side Effects● ● ● history of drug abuse or dependence • Porphyria • Uncontrolled severe pain • Intra-arterial or subcutaneous administration • LactationUse Cautiously in:● with hepatic, renal, cardiac, or respiratory impairment • Depressed or suicidal patients • Pregnancy • Children● ● Interactions● ● ● ● ● ● ● ●^514 ConfusionDecreased effects of the following drugs with concurrent use of (ConstipationAgitationSkin rashesSomnolenceRespiratory depressionHypotensionPhysical and psychological dependenceBradycardiaIncreased effects of barbiturates with monoamine oxidase Additive CNS depression with Decreased effects of barbiturates with Nausea, vomitingdepressantsMAO) inhibitors^ ●^ PSYCHOTROPIC MEDICATIONS or • Elderly and debilitated patients • Patients valproic acidalcohol rifampinand other CNS
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