Talk to your doctor before taking this medicine, if you:

• are allergic to RYTHEM PLUS 4/2mg or any of the other ingredients of this medicine
• have a heart problem or stroke
• have ever experienced involuntary movements of the tongue, mouth and face
• have Parkinson’s disease or dementia
• have had low levels of white blood cells in the past
• are diabetic
• have problems controlling your body temperature or overheating
• have kidney or liver problems
• have an abnormally high level of the hormone prolactin in your blood
• have glaucoma
• have prostate problem
• have trouble passing urine
• have a stomach ulcer or suffer from severe heartburn or acid indigestion or any other digestive disorders
• suffer from a condition called myasthenia gravis
• suffer from tardive dyskinesia (unusual movements of the face and tongue)

• You should not take this medicine if you are pregnant or breast feeding
• Consult your doctor for advice

• Children and adolescents under 18 years old should not be treated with RYTHEM PLUS 4/2mg

• RYTHEM PLUS 4/2mg can cause blurred vision or dizziness
• Do not drive or operate machinery if this happens to you

• dementia and sudden change in your mental state or sudden weakness or numbness of your face, arms or legs, especially on one side, or slurred speech, even for a short period of time
• tardive dyskinesia (twitching or jerking movements that you cannot control in your face, tongue, or other parts of your body)
• involuntary rhythmic movements of the tongue, mouth and face

• pneumonia, infection of the chest (bronchitis), common cold symptoms, sinus infection, urinary tract infection, ear infection, feeling like you have the flu
• weight gain, increased appetite, decreased appetite
• sleep disorder, irritability, depression, anxiety, restlessness
• dystonia, dizziness, dyskinesia, tremor (shaking)
• blurry vision, eye infection or pink eye
• rapid heart rate, high blood pressure, shortness of breath
• sore throat, cough, nose bleeds, stuffy nose
• abdominal pain, abdominal discomfort, vomiting, nausea, constipation, diarrhea indigestion, dry mouth, toothache
• rash, skin redness
• muscle spasms, bone or muscle ache, back pain, joint pain
• incontinence (lack of control) of urine
• swelling of the body, arms or legs, fever, chest pain, weakness, fatigue (tiredness) pain
• blurring of vision or dizziness
• feeling sick or nervous

• decrease in number of white blood cells
• diabetes or worsening of diabetes, high blood sugar, excessive drinking of water
• increased cholesterol in your blood
• elated mood (mania), confusion, decreased sexual drive, nervousness, nightmares
• unresponsive to stimuli, loss of consciousness, low level of consciousness
• convulsion (fits), balance disorder
• oversensitivity of the eyes to light, dry eye, increased tears, redness of the eyes
• sensation of spinning (vertigo), ringing in the ears, ear pain
• atrial fibrillation (an abnormal heart rhythm)
• stomach or intestinal infection, stool incontinence, very hard stool, difficulty swallowing, excessive passing of gas
• an increase of CPK (creatine phosphokinase) in your blood, an enzyme which is sometimes released with muscle breakdown
• abnormal posture, joint stiffness, joint swelling, muscle weakness, neck pain
• frequent passing of urine, inability to pass urine, pain when passing urine
• loss of menstrual periods, missed menstrual periods or other problems with your cycle (females)
• development of breasts in men, leakage of milk from the breasts, sexual dysfunction, breast pain, breast discomfort, vaginal discharge
• swelling of the face, mouth, eyes, or lips
• chills, an increase in body temperature
• feeling thirsty, feeling unwell, chest discomfort

• sugar in the urine, low blood sugar, high blood triglycerides (a fat)
• lack of emotion, inability to reach orgasm
• coma due to uncontrolled diabetes
• shaking of the head
• glaucoma (increased pressure within the eyeball), problems with movement of your eyes, eye rolling, eyelid margin crusting
• dangerously excessive intake of water
• irregular heart beat
• trouble breathing during sleep (sleep apnea), fast, shallow breathing
• inflammation of the pancreas, a blockage in the bowels
• swollen tongue, chapped lips, rash on skin related to drug
• dandruff
• breakdown of muscle fibers and pain in muscles (rhabdomyolysis)
• increased insulin (a hormone that controls blood sugar levels) in your blood
• hardening of the skin
• decreased body temperature, coldness in arms and legs
• yellowing of the skin and the eyes (jaundice).
• feelings of confusion or delusion (loss of reality)
• difficulty in sleeping
• false sense of well-being
• immediate or short-term memory loss
• worsening of myasthenia gravis (very tired or weak muscles)
• large pupils and lack of near vision
• eye discomfort and increased sensitivity to light
• painful increased pressure in the eye
• faster heartbeat
• reddening and dryness of skin or skin rashes
• inability to pass urine or difficulty passing urine
• increased thirst
• fever

• life threatening complications of uncontrolled diabetes
• serious allergic reaction with swelling that may involve the throat and lead to difficulty breathing
• lack of bowel muscle movement that causes blockage
• difficulty breathing or tightness in the chest
• difficulty swallowing