These transient withdrawal signs increased locomotion, body twitching, and aversive behavior toward the observer were not reversed by naloxone administration. WebMD User Reviews should not be considered as medical advice and are not a substitute for professional medical advice, diagnosis, or treatment. Never delay or disregard seeking professional medical advice from your physician or other qualified healthcare provider because of something you have read on WebMD. You should always speak with your doctor before you start, stop, or change any prescribed part of your care plan or treatment. WebMD understands that reading individual, real-life experiences may be a helpful health information resource but they are never a substitute for professional medical advice from a qualified healthcare provider. dutasteride price in jordan dutasteride
Discussed the knee with an orthopedic surgeon and was advised that they could do arthroscopy surgery but there would be no guarantee of not having pain afterwards and they weren't sure if it would even help. Cordarone amiodarone hydrochloride US prescribing information. Wyeth Pharmaceuticals April, 2016. Concomitant use of ciprofoxacin and Zanaflex is contraindicated. Changes in pharmacokinetics of tizanidine when administered with ciprofloxacin resulted in significantly decreased blood pressure, increased drowsiness, and increased psychomotor impairment.
Read the Guide provided by your professional before each injection. The initials "DC" identify a chiropractor, whose education typically includes an undergraduate degree plus four years of chiropractic college. What Does Chiropractic for Back Pain Involve? Zanaflex is to be used only by the patient for whom it is prescribed. Do not share it with other people. Do not take more than three doses 36 mg of tizanidine in a 24-hour period. Too much of this medication can damage your liver.
Changes in sleeping or eating habits, less attention to dressing and grooming, or less interest in sex. Each treatment cycle consists of two injections 1 to 3 days apart and a modeling straightening procedure 1 to 3 days after the second injection. Do not have between the first and second injections of a treatment cycle. Tell your doctor right away if you start to feel numbness, tingling, or a feeling of "pins and needles" in your hand during the procedure. PREGNANCY and BREAST-FEEDING: It is not known if Zanaflex can cause harm to the fetus. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Zanaflex while you are pregnant. It is not known if this medicine is found in breast milk. If you are or will be breast-feeding while you use Zanaflex, check with your doctor. Discuss any possible risks to your baby.
Tell your doctor if you have trouble or straightening your penis or if new pain occurs. On the other hand, a third study slated for the meeting had results that were not that promising. The researchers looked at about 300 patients who had an initial Botox injection to treat incontinence between 2010 and 2014 to determine the treatment's impact on acute urinary retention. If you are still unable to straighten your finger after 4 weeks, your doctor may give a repeat injection into the same area of the hand. No more than 3 injections, each 4 weeks apart, should be given in the same area. You should have been with me when our son was helping me to clean the kitchen one night. Oh ya, my short term memory is gone. My wife has been yelling at me for a couple of years because I forget stuff so easily. When we found out about the MS three weeks ago one of the first things I said to her was "See, I'm not ignoring you, I really can't remember! What are drug abuse and dependence? This is the first of any kind of site I have found that is even remotely close to what I am experiencing. I have joint pain in most of my joints but it is all on the left side. It started out as just my neck several years ago and now includes, neck, shoulder, wrist, lower back, hip, knee and ankle. I have been to numerous specialists including orthopedic surgeons and rhumatologists and so far no luck. DISH and this med is the only thing that is working for me. Pain meds either don't touch the pain or are too strong for me. This does sedate me about an hour after taking it but it only lasts for around an hour and then I can resume my activities so I plan around that. I am very satisfied with Zanaflex as this is the only thing along with ibruprophen that is helping with my DISH right now. I take 4mg and might have to take another 2mg 4-6 hours later as relief is short lived and it depends on what I have to do that day but I have never needed over 16mg a day. I am very happy with this med. This is not a complete list of possible side effects. Side Effects List Ambien side effects by likelihood and severity. What is the most important information I should know about tizanidine Zanaflex? This information should not be used to decide whether or not to take Zanaflex or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about Zanaflex. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to Zanaflex. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your health care provider for complete information about the risks and benefits of using Zanaflex. Food can change the way your body absorbs and uses Zanaflex. Be sure to discuss this with your doctor to determine the best way to take your dose, especially when changes to your dose are being considered, or if you are being prescribed a different dose form of Zanaflex eg, tablets or capsules. What are the possible side effects of tizanidine Zanaflex? Now for some reason I don't get them at all after I ended with severe TMJ in the last 3 months after a dental procedure. Actually I noticed a year ago that my bite was getting smaller. Sometimes I could barely open it and I would do exercises to move my jaw so that it would move back into place the same or next day. But just recently after several dental procedures it was too much for my jaw and it locked up. So I have been seeing a TMJ Specialist over 200 miles away in another city doing physical therapy and both things with some medications only when I feel pain has helped so much. Before I could only open my mouth 4 mm now I'm at a typical 40mm. I still have concerns with how my ears feel all the time since the TMJ is so close to all the ear functions. But as I go down the right side body parts there's more. I get tension in my neck on the right side. My right arm and hand has pain when I write too much or when playing sports. Then my back only on the right side is a total story in itself but I was told by my primary doctor that it was mild scoliosis but the pain is not so mild especially because I have four kids so I stay active almost all the time. Also when I walk I can tell that right side foot points out instead of straight like my left foot so I am sure something is going on there especially because my knee pops. Even after all this I try to stay positive, have a good attitude and continue to do things but of course know my limits. I know that feeling though about getting the crazy looks. Unfortunately I have had no diagnosis to sum it all up I guess because I continue to do the regular things but with some pain. My primary doctor just has me come in every six months to see how I am doing since my symptoms are mild but slowly but surely going into the moderate range as I am getting older 33. I wish you luck and just letting you know that someone else shares your concerns. Concomitant use of fluvoxamine and Zanaflex is contraindicated. Changes in pharmacokinetics of tizanidine when administered with fluvoxamine resulted in significantly decreased blood pressure, increased drowsiness, and increased psychomotor impairment.
What I would encourage you to do is go to your doctor and describe this foot and ankle pain and stiffness. A physical--or what is called a "neurologic" exam--will determine whether you have spastic muscles. There are medications such as muscle relaxers that treat this condition. Personally, I take baclofen for my leg spasticity. You don't need a disease diagnosis to be treated for spastic muscles, by the way. The opinions expressed in WebMD Communities are solely those of the User, who may or may not have medical or scientific training. These opinions do not represent the opinions of WebMD. Communities are not reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other reason except for compliance with our Terms and Conditions. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345. She puts it on with those water crayons. I get a reminder every day when I give the kids a bath about what is coming up. She has one on the fridge in the kitchen too to glance at while I am cleaning up after dinner. I'm 52 and have been told that I have arthritis in my knee, plantars fasciitis in my right foot, and cervical arthritis on the right side of my neck. It's your choice to begin using a drug. But as you use it more, your begins to change. This change can lead to a craving to use the drug, and this can influence how you act. Which drugs might be a problem? Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine. tamoxifen
This is used to treat certain conditions , that are caused by a certain protein in your body. The goals of chiropractic care include the restoration of function and prevention of injury in addition to back pain relief. What Are the Benefits and Risks of Chiropractic Care? Roughly nine in 10 patients saw a 50 percent or greater drop in daily episodes. Between 44 percent and 52 percent of patients saw all episodes end. Do not take more than the recommended dose or use for longer than prescribed without checking with your doctor. If you stop using the drug, you feel sick. This is known as withdrawal. Cipro ciprofloxacin hydrochloride US prescribing information. Bayer Corporation July, 2016. Switching between tizanidine tablets and capsules, or changing the way you take it with regard to eating, can cause an increase in side effects or a decrease in therapeutic effect. Follow your doctor's instructions carefully. After making any changes in how you take tizanidine, contact your doctor if you notice any change in how well the medicine works or if it causes increased side effects. Wow--another Ehlers Danlos patient! Spinal manipulation and chiropractic care is generally considered a safe, effective treatment for acute low back pain, the type of sudden injury that results from moving furniture or getting tackled. The amount of tizanidine in your blood may increase and cause more side effects than normal, including severe low blood pressure and drowsiness.
Tizanidine is closely related to clonidine, which is often abused in combination with narcotics and is known to cause symptoms of rebound upon abrupt withdrawal. Three cases of rebound symptoms on sudden withdrawal of tizanidine have been reported. The case reports suggest that these patients were also misusing narcotics. Withdrawal symptoms included hypertension, tachycardia, hypertonia, tremor, and anxiety. Withdrawal symptoms are more likely to occur in cases where high doses are used, especially for prolonged periods, or with concomitant use of narcotics. If therapy needs to be discontinued, the dose should be decreased slowly to minimize the risk of withdrawal symptoms. Dizziness; drowsiness; dry mouth; tiredness; weakness. Nitti and his colleagues analyzed data on 227 patients who received Botox injections averaging less than two shots per year over a four-year period. In addition, hypotension and bradycardia were observed. The occurrence of these reactions is summarized in Table 2. Other events were, in general, reported at a rate of 2% or less. TMJ specialist to eventually have orthognathic surgery to improve pain from possible arthritis as well as chewing function and just basic alignment of my teeth. I also have dealt with recurring "tendonitis" in my right hip, chondromalacia of the knee, and another "tendonitis" diagnosis on my hand. I was tested for rheumatoid arthritis about a year ago and it was ok, but I wanted to be tested because it runs in the female side of my family. It just occurred to me recently that I only have problems on my right side. Maybe it's because I use it more, but I wonder if that is a significant factor at all. Every time I go to see the doctor I get this look like I am just crazy or something. I am 30 years old and otherwise extremely healthy. I also eat very well and exercise every day for about 20 minutes each time. I am at a loss, but the pain I am dealing with is sometimes much more than I can handle. It is definitely affecting my quality of life and makes it hard for me to do the daily activities I want to do. I need advice. Is anybody out there that has dealt with a similar problem. The amount of tizanidine in your blood may increase and cause more side effects than normal, including severe low blood pressure and drowsiness. Also, taking amiodarone or propafenone with tizanidine may increase your risk of an irregular heartbeat, which may be life-threatening. Store Zanaflex at 77 degrees F 25 degrees C. Brief storage at temperatures between 59 and 86 degrees F 15 and 30 degrees C is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Zanaflex out of the reach of children and away from pets. Helping someone who has a drug problem is hard. If you are "" for the person, you need to stop. For example, don't make excuses for the person when he or she misses work. Zanaflex should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed. what is the generic for podophyllotoxin
What are the signs of drug abuse and dependence? The opinions expressed in WebMD User-generated content areas like communities, reviews, ratings, or blogs are solely those of the User, who may or may not have medical or scientific training. These opinions do not represent the opinions of WebMD. User-generated content areas are not reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other reason except for compliance with our Terms and Conditions. My hand just let it go and drop to the floor. It's a good thing that I do not trust myself to far anymore. Ciprofloxacin may slow down how quickly your liver processes tizanidine. RX drugs and my stomach can't take alot of this stuff. Fingers Crossed! Muscle relaxants are sometimes combined with another medicine.
You continue to use the drug even though it harms your and causes you to develop physical problems. How are drug problems treated? Do not take tizanidine if you are also taking the antidepressant Luvox or the antibiotic Cipro. Severe allergic reactions rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, throat, or tongue; unusual hoarseness; blurred vision; change in emotions, mood, or behavior; fainting; frequent, difficult, or painful urination; hallucinations; increased muscle spasms; muscle weakness; red, swollen, blistered, or peeling skin; slow heartbeat; severe or persistent dizziness or light-headedness; symptoms of liver problems eg, yellowing of the skin or eyes; dark urine; pale stools; nausea; stomach pain; loss of appetite; unusual tiredness. Started taking two weeks ago only 2mg. at bedtime, but that didn't help my TMD muscle spasms in daytime so last week Dr. had me taking 2mg. at 10am, 4pm and 4mg at bedtime. After second day I started waking up around 6am with chills and nervous stomach, but continued schedule for a week. Last night I cut back bedtime dose to 2mg. and didn't feel as bad this morning and I'm only going to take 2mg in afternoon and 2mg. at bedtime tonight. generic hydrochlorothiazide online cost
Church, have a special project, and Love your family to name a few. This is not for sissies, so toughen up. Work with your neuro and get your medicinal program implemented. Remember to be your own best advocate. We need our neuros but, they're basically just keeping records on us. You are going to experience more strange feelings, emotions, and sensations than imaginable. I retired as soon as possible because we can never get get the time back. Good luck and May God Bless you. I apologize for my incontinence of thought, run on sentences, and poor punctuation. Like you, it hits while sitting still, and it's worst at night when I'm trying to sleep. Sometimes gentle massage of the area relieves it, other times, my feet are just so hypersensitive that touching them is torture. Soaking my feet in cool water helps me as well. I've often had to get up in the middle of the night to sit on the edge of the tub soaking my piggies. Find tips and advances in treatment. Here is a collection of user reviews for the medication Zanaflex sorted by most helpful. Anyway, as I said, "Take heart! Momo K, Homma M, Kohda Y, Ohkoshi N, Yoshizawa T, Tamaoka A. Drug interaction of tizanidine and ciprofloxacin: case report. Nitti also led a second investigation that looked at how slightly more than 250 patients -- from an earlier trial -- continued to fare while receiving between one and six additional Botox injections over a three-year follow-up study. Let me start by saying that I take a lot of natural supplements every day, but if I had to choose only one, it would be MSM. If my joints are a bit sore I take 1 teaspoon mixed in juice twice a day until the pain goes, in about 3 days then one teaspoon a day is enough. One tspn is 4 grams. Some medical conditions may interact with Zanaflex.
Concomitant use of Zanaflex with oral contraceptives is not recommended. That must have been a really embarrassing situation with The Big Cheese at work. I might have had a little moment of almost crying about that one later by myself. Using tiZANidine together with zolpidem may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol during treatment. In addition, these medications may also have additive effects in lowering your blood pressure. All of the patients had been diagnosed with a form of for which no specific underlying cause could be identified. Tell your doctor or dentist that you take Zanaflex before you receive any medical or dental care, emergency care, or surgery. Here is the worst I have experienced. Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take. If you have any questions about Zanaflex, please talk with your doctor, pharmacist, or other health care provider. Monitor patients who take Zanaflex with another CNS depressant for symptoms of excess sedation. You are getting older and are overweight. permethrin
If you need to write down a name on your hand and give it a quick glance before your meeting. I make seating charts of where folks are sitting in a meeting and jot down their name when they are introduced. Take care, and let us know what you do to help. My memory on the other hand isn't too shabby either boy i tell you some days are okay but others make me feel like i'm imagining that these things are happening to me and that's just the tip of the iceberg. I do have the brain lesin on the right side. But on the flip side of it all i'm still alive and i have a very healthy 11 yr old daughter. I THANK GOD EVERYDAY WHEN I WAKE UP AND IF I FORGET I STILL THANK HIM IN ADVANCE. Amiodarone, mexiletine, propafenone, and verapamil may slow down how quickly your liver processes tizanidine. Also, amiodarone, propafenone, and tizanidine can cause a certain type of irregular heartbeat. Because clinical studies are conducted under widely varying conditions, reaction rates observed in the clinical studies of a drug cannot be directly compared to rates in the clinical studies of another drug and may not reflect the rates observed in clinical practice. Among people seeking relief alternatives, most choose treatment. About 22 million Americans visit chiropractors annually. Serious. These medicines may interact and cause very harmful effects. Granfors MT, Backman JT, Neuvonen M, Neuvonen PJ. Ciprofloxacin greatly increases concentrations and hypotensive effect of tizanidine by inhibiting its cytochrome P450 1A2-mediated presystemic metabolism. You might have as many as 4 treatment cycles. Each treatment cycle is about 6 weeks apart. It sounds as though your doctor is doing the right things as far as testing you for MS and keeping an eye on you for follow-up. Having a clear lumbar puncture doesn't rule out MS. An MS diagnosis is made by looking at a variety of test results, looking at the symptom history and neurologic exams. Part of diagnostic testing is ruling out other causes, and this can be done with a panel of blood tests to check for diabetes, Lyme, and a bunch of other things that would show up in the blood serum which MS does not. In the meantime, it's important that you keep a symptom log and call your doc whenever something new flares up, or something old worsens and causes you pain and distraction. DISH and this med is the only thing that is working for me. Pain meds either don't touch the pain or are too strong for me. This does sedate me about an hour after taking it but it only lasts for around an hour and then I can resume my activities so I plan around that. Finally, it dawned on me that it is all on the right side. In my initial Internet search, I discovered that it can be linked to Crohn's Disease, which was an "aha" for me, because my doctor diagnosed me with IBS Irritable Bowel Syndrome earlier this year. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. Drugs. The following adverse reactions have been identified as occurring in the post marketing experience of Zanaflex. Based on the information provided regarding these reactions, a causal relationship with Zanaflex cannot be entirely excluded. The events are listed in order of decreasing clinical significance; severity in the post marketing setting is not reported.
Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first. Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. But there is little research on their use for neck pain. Read the Zanaflex tizanidine Side Effects Center for a complete guide to possible side effects. All medicines may cause side effects, but many people have no, or minor side effects. It sometimes takes quite a while and a lot of tests to get a positive diagnosis. The injury may require surgery to repair. Tell your doctor right away if you have difficulty moving your fingers or hand after your doctor has told you it is okay to move them. Your doctor will ask questions about your symptoms and past health. See Drug Reference for a full list of side effects. Drug Reference is not available in all systems. This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. cheap isotrexin order visa europe
Call for most recent medications as the list is subject to change and the medication for which you are seeking assistance must treat the disease directly. Note: All new enrollment is now done electronically or over the phone. Contact program for details. Manipulation is used to restore mobility to joints restricted by tissue injury caused by a traumatic event, such as falling, or repetitive stress, such as sitting without proper back support. All treatment is based on an accurate diagnosis of your back pain. The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply. The following adverse reactions have been identified during post approval use of Zanaflex. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. Sneaky behavior, lying, or stealing. Zanaflex tizanidine hydrochloride US prescribing information. Acordia Therapeutics, Inc. July, 2006. If a partner or friend thinks you have a drug problem, he or she may urge you to see your doctor. Muscle relaxants are recommended only for initial, short-term treatment of neck pain. If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Drug dependence is a disease. Perhaps the same is true for you and others who have posted here. BUT I was also diagnosed with degenerative disc in my cervical spine 5 years ago, when I was 35, so it could "just" be more degeneration. That research team, led by Dr. Olufenwa Milhouse, an urologist in Woodbury, Minn.
Some MEDICINES MAY INTERACT with Zanaflex. Up-and-down moods, a mood or attitude that is getting worse, or not caring about the future. After you stop using drugs, you focus on staying drug-free. Most people receive some type of therapy, such as group counseling. You also may need medicine to help you stay drug-free. Three-quarters of the patients rated the events as mild to moderate and one-quarter of the patients rated the events as being severe. These events appeared to be dose related. New problems at work or school, or problems with the law. Drug abuse can lead to drug dependence, where you are to a drug. The drug controls your life. Do not consider WebMD User-generated content as medical advice. Never delay or disregard seeking professional medical advice from your doctor or other qualified healthcare provider because of something you have read on WebMD. You should always speak with your doctor before you start, stop, or change any prescribed part of your care plan or treatment. WebMD understands that reading individual, real-life experiences can be a helpful resource but it is never a substitute for professional medical advice, diagnosis, or treatment from a qualified health care provider. If you think you may have a medical emergency, call your doctor or dial 911 immediately. Complete the What is a document? Club drugs, such as ecstasy MDMA. Three double-blind, randomized, placebo controlled -clinical studies were conducted to evaluate the effect of tizanidine on spasticity control. Two studies were conducted in patients with multiple sclerosis and one in patients with spinal cord injury. Report Problems to the Food and Drug Administration. This way you and your doc are creating a history of symptoms to refer to down the road, and any uncomfortable symptoms are being treated so you can maintain your quality of life. No matter what your diagnosis turns out to be, your personal symptom history is how your disease is affecting you, and that's the most important thing to know. Usually the benefits of the medicine are more important than any minor side effects. To gain full recovery, you need to take steps to improve other areas of your life, such as learning to deal with your work, family, and living situation in healthy ways. This makes it easier to stay drug-free. What can you do if you or another person has a problem with drugs? Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication not have serious side effects. How are drug problems diagnosed? purchase apetamin-p online usa
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And do let us know what you learn. Do not stop taking any medications without consulting your healthcare provider. Botox is not just for wrinkles anymore. ikuro.info glimepiride
The first step in treatment is to quit using drugs. You may need medical care to manage symptoms when you first quit. Your hand will be wrapped in soft gauze after the injection. Patients must have health insurance and their insurance must cover the qualifying medication for which they seek assistance. The treatment plan may involve one or more manual adjustments in which the doctor manipulates the joints, using a controlled, sudden force to improve range and quality of motion. But, the study authors added, 40 percent of patients chose to have a second Botox injection.
Check with your pharmacist about how to dispose of unused medicine. Cold or allergy medicine, narcotic pain medicine, sleeping pills, other muscle relaxers, and medicine for seizures, or can add to sleepiness caused by tizanidine. Tell your doctor if you need to use any of these other medicines together with tizanidine. You are getting older and are overweight. We can send you for therapy and put you on meds but there is no guarantee that will help. Do not consider Communities as medical advice. Never delay or disregard seeking professional medical advice from your doctor or other qualified healthcare provider because of something you have read on WebMD. You should always speak with your doctor before you start, stop, or change any prescribed part of your care plan or treatment. WebMD understands that reading individual, real-life experiences can be a helpful resource, but it is never a substitute for professional medical advice, diagnosis, or treatment from a qualified health care provider. If you think you may have a medical emergency, call your doctor or dial 911 immediately. salbutamol
You may be able to help by talking to the person about what his or her drug use does to you and others. Talk to the person in private, when he or she isn't using drugs or alcohol and when you are both calm. If the person agrees to get help, call for an appointment right away. Don't wait. Use Zanaflex as directed by your doctor. Check the label on the medicine for exact dosing instructions. Started taking two weeks ago only 2mg. at bedtime, but that didn't help my TMD muscle spasms in daytime so last week Dr. had me taking 2mg. at 10am, 4pm and 4mg at bedtime. After second day I started waking up around 6am with chills and nervous stomach, but continued schedule for a week. Last night I cut back bedtime dose to 2mg.