Contraindicated in:

• Hypersensitivity;
• MI, unstable angina, stroke, transient ischemic attack, or class III or IV HF within previous 6 mo;
• 2nd- or 3rd-degree heart block or sick sinus syndrome (in the absence of a pacemaker);
• QT interval ≥500 msec;
• Cardiac arrhythmias requiring use of class Ia or III antiarrhythmics;
• Active acute/chronic untreated infections;
• OB: Pregnancy.

Use Cautiously in:

• History of ischemic heart disease, MI, HF, cerebrovascular disease, uncontrolled hypertension, AV or SA heart block, symptomatic bradycardia, recurrent syncope, cardiac arrest, or severe untreated sleep apnea (↑ risk of bradycardia/heart block);
• QT interval prolongation before or during observation period (>450 msec in adult and pediatric males, >470 msec in adult females, >460 msec in pediatric females), hypokalemia, hypomagnesemia, congenital long QT syndrome, or concurrent use of QT interval prolonging medications (↑ risk of QT interval prolongation);
• Severe hepatic impairment;
• Diabetes mellitus/history of uveitis (↑ risk of macular edema);
• Negative history for chickenpox or vaccination against varicella zoster virus (VZV) vaccination;
• Lactation: Use while breastfeeding only if potential maternal benefit justifies potential risk to infant;
• Rep: Women of reproductive potential;
• Pedi: Children <10 yr (safety and effectiveness not established);
• Geri: Risk of adverse reactions may be ↑ in older adults; consider age-related ↓ in cardiac/renal/hepatic function, chronic illnesses, and concurrent drug therapy.