Patient/Family Teaching

• Instruct patient to take medication at least 6 hr before bedtime to avoid sleep disturbances. Missed doses should be taken as soon as remembered up to 6 hr before bedtime. With extended release capsule, avoid afternoon doses to prevent insomnia. Do not double doses. Advise patient and parents to read the Medication Guide prior to starting therapy and with each Rx refill. Instruct patient not to alter dose without consulting physician. Abrupt cessation of high doses may cause extreme fatigue and mental depression

• Inform patient that the effects of drug-induced dry mouth can be minimized by rinsing frequently with water or chewing sugarless gum or candies

• Advise patient to limit caffeine intake

• May impair judgment. Advise patient to use caution when driving or during other activities requiring alertness

• Inform patient that periodic holidays from the drug may be used to assess progress and decrease dependence. Pedi: Children should be given a drug-free holiday each year to reassess symptoms and treatment. Doses will change as children age due to pharmacokinetic changes such as slower hepatic metabolism

• Advise patient and/or parents to notify health care professional of behavioral changes

• Advise patient to notify physician if nervousness, restlessness, insomnia, dizziness, anorexia, or dry mouth becomes severe. Pedi: If reduced appetite and weight loss are a problem, advise parents to provide high calorie meals when drug levels are low (at breakfast and or bedtime)

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