 Pay close attention to and call your doctor if you become depressed, have sudden changes in mood, or have suicidal thoughts. Don't take if you have liver problems or are taking reserpine, tetrabenazine, or valbenazine. Osteto XR may cause irregular or fast heartbeat or abnormal movements. Seek help for fever, stiff muscles, problems thinking, or sweating. Common side effects include inflammation of the nose and throat, insomnia, and sleepiness. Ask your doctor for Osteto XR.