NIMULAR SP 100MG CAPSULE

Talk to Doctor
Tell your doctor before taking this medicine, if you:
- are allergic (hypersensitive) or any of the other ingredients of this medicine
- are undergoing Electroconvulsive therapy (ECT)
- have suffered from abnormally elevated mood (mania) in the past
- have any liver or kidney problems
- suffer from congenital heart defect
- have diabetes
- have a history of bleeding disorders
- have raised intraocular pressure or are at risk of acute narrow-angle-glaucoma
- are depressed or have anxiety disorders you can sometimes have thoughts of harming or killing yourself
- are an alcoholic

Pregnancy & Breast Feeding
- Caution should be exercised when used during pregnancy, especially during late pregnancy or just before giving birth
- This medicine is excreted in breast milk and may cause side effects in babies
- Talk to your doctor as soon as possible if you are pregnant or might be pregnant, planning to become pregnant or breast feeding

Children & Adolescents
- You should not be used in children and adolescents under the age of 18

Driving & Using Machines
- Do not drive or use machinery unless you are sure that you are not affected

- Always take this medicine exactly as your doctor has told you
- Do not chew or crush the medicine
- Swallowed the medicine whole, with a drink of water
- Dose may depend on your age and disease condition
The recommended dose are as follows
Your doctor will review and adjust your dosage if necessary within 3 to 4 weeks of the start of treatment. When appropriate the dosage can be gradually increased up or down as per requirement.
If you take too many capsules, go to your nearest hospital tell your doctor straight awaySymptoms of overdose include: nausea, vomiting, seizures, heart problems (like irregular heartbeat and cardiac arrest), lung problems and change in mental condition ranging from agitation to coma
If you forget to take your dose, do not worry. Take your next dose the next day at the usual time. Do not take a double dose to make up for a forgotten individual dose. Taking your medicine at the same time each day may help you to remember to take it regularly
Keep taking your medicine until your doctor asks you to stop. Do not stop taking your medicine without asking your doctor first, even when you start to feel better

Serious
Like all medicines, this medicine can cause side effects, although not everybody gets them.
- allergic reaction such as rash, itching, swollen lips, tongue or face, wheezing or shortness of breath
- faster breathing or heart rate, sweating, muscle stiffness or tremor, confusion, extreme agitation or sleepiness
- prolonged and painful erection
- irritability and extreme agitation
- heart problems, such as fast or irregular heart rate, fainting, collapsing or dizziness upon standing which may indicate abnormal functioning of the heart rate
- inexplicable vaginal bleeding
- inexplicable bruises or bleeding or bleeding in the gastrointestinal tract
- fits
- uncontrollable movements
- signs of liver inflammation (abdominal swelling, distention or bloating, diarrhoea, discolored urine and stool, fatigue, headache, itchy skin, joint pain, loss of appetite, low-grade fever, malaise and lethargy, nausea with or without vomiting, yellowing of the skin and whites of the eye)
- small bleedings of skin and mucosa, painless (rarely itching) skin swelling, acute, inflammatory skin disease, heavy skin reactions Stevens-Johnson Syndrome, erythema multiforme, toxic epidermal necrolysis (Lyell syndrome)

Common
Like all medicines, this medicine can cause side effects, although not everybody gets them.
- poor appetite
- change in taste
- nervousness, anxiety
- feeling tensed
- decreased sex drive or sexual difficulties (including low sexual performance and ejaculation problems)
- sleep problems or unusual dreams
- tremor
- drowsiness
- blurred vision
- flushing
- yawning
- indigestion, vomiting
- joint pains
- passing urine too frequently
- feeling shaky or chills
- weight loss
- headache, dry mouth

Uncommon
Like all medicines, this medicine can cause side effects, although not everybody gets them.
- feeling detached from yourself
- abnormal thinking
- abnormally high mood
- orgasm problems
- teeth grinding
- disturbances of motion sequence or coordination
- muscle twitching
- involuntary impaired balance
- memory impairment
- enlarged pupils
- ringing in the ears
- low blood pressure
- nose bleeds
- difficulties in swallowing
- hair loss
- cold sweat
- feeling hot or cold

Rare
Like all medicines, this medicine can cause side effects, although not everybody gets them.
- low levels of sodium in the blood
- low numbers of blood cells
- low number of manic reactions (untypical wild behavior)
- hallucinations
- uproariousness, aggression
- panic attacks, stuttering or agitation
- buccoglossal syndrome
- arrhythmias and QT prolongation
- inflammation of blood vessels and vascular
- dilation
- pharyringitis
- oesophageal pain
- lung problems
- sensitivity to sun light
- muscle aches
- producing breast milk
- serum sickness (rash, joint aches, fever, swelling of lymph nodes, shock, low blood pressure)
- impaired ADH secretion
- increased prolactin levels in the blood
- abnormal liver function tests

Tell your doctor, if you are taking, have recently taken or might take any other medicines such as:
- lithium, pimozide, haloperidol or phenothiazines for mental illness
- sparfloxacin, moxifloxacin, erythromycin IV, pentamidine (anti-biotics, used to treat infections)
- Used for anti-malaria treatment
- iproniazid, linezolide and methylthioninum chloride
- Used for heart failure
- Uused to treat high blood pressure
- Used to treat abnormal heart rhythms
- Used to treat attention deficit hyperactivity disorder - ADHD
- Used to treat psychotic disorders
- Water tablets
- Used to reduce amount urine produced by kidneys
- Used to treat epilepsy
- Tramadol for pain relief
- Used to help stop smoking
- Used to treat breast cancer

- Keep this medicine out of reach of children
- Do not use this medicine after the expiry date