Duram Plus 10mg/20mg Tablet is a combination of two medicines used for the treatment of anxiety. It alters the chemicals in the brain that cause symptoms of anxiety such as irritability, restlessness, lack of concentration, fatigue, sweating, increased heart rate, and unwanted or racing thoughts. Duram Plus 10mg/20mg Tablet helps to increase the level of a chemical messenger in the brain which improves mood. It also blocks the action of certain chemical messengers on the heart and blood vessels. This reduces heart rate and blood pressure. It may be taken with or without food. However, it is better to take this at the same time each day. Take this medicine in the dose and duration advised by your doctor. If you miss a dose of this medicine, take it as soon as you remember. Do not skip any doses and finish the full course of treatment even if you feel better. It is important not to stop taking this medicine suddenly as it can result in serious withdrawal symptoms. Remember that your doctor will probably decrease the dose gradually to avoid such effects. Some common side effects of this medicine include nausea, diarrhea, vomiting, low sexual desire, delayed ejaculation, tiredness, cold extremities, slow heart rate, Raynaud phenomenon, and nightmares. However, these are temporary and usually resolve on their own. Please consult your doctor if these do not subside or bother you. It even causes dizziness and sleepiness, so do not drive or do anything that requires mental focus until you know how this medicine affects you. Inform your doctor if you develop any unusual changes in mood as it may cause suicidal thoughts and can be dangerous for you.