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Increased risk of drug-related mortality from concomitant use with opioids. Suicidal thoughts or behavior (monitor). Depression. May increase or precipitate tonic-clonic seizures. Compromised respiratory function (eg, COPD, sleep apnea). Porphyria. Monitor LFTs, CBCs during long-term therapy. Assess patient's risk for abuse, misuse, addiction prior to and during therapy. Avoid abrupt cessation. Withdraw gradually. Drug or alcohol abusers. Renal impairment. Elderly. Labor & delivery. Pregnancy. Nursing mothers.
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