👨‍⚕️ Clinically Reviewed by: PakistaniBano Medical Editorial Board (Pharm.D Panel)
📅 Reviewed: November 2026 • 🔍 Authority: DRAP / WHO ATC
📦 Formulations, Pack Sizes & Retail Prices Currency: Rs.
Dosage Form Reg. No Pack Size Trade Price (TP) Maximum Retail Price (MRP)
Cap 20 % 032339 2x7 Rs.59.50 Rs.70.00

📋 Indications & Clinical Dosage

*Major depression:* Adult: Initially 20 mg daily, dose is increased after 3-4 weeks if necessary, and at appropriate intervals thereafter, daily dose may be administered as a single or divided dose; max. 60 mg per day. Elderly: Initially 20 mg daily, dose is increased after 3-4 weeks if necessary, and at appropriate intervals thereafter, daily dose may be administered as a single or divided dose; max. 40 mg per day but doses up to 60 mg daily can be used Children 8 yrs: Initially 10 mg per day, increase to 20 mg per day after 1 week; may be increased further after several weeks if clinical improvement not observed; max 40 mg per day. *Bulimia nervosa:* Adult: 60 mg daily as a single or divided dose. Elderly: Up to 40 mg daily as a single or divided dose, usual max. dose is 40 mg daily but doses up to 60 mg daily can be used. *Obsessive-compulsive disorder:* Adult: 20 mg daily as a single or divided dose, increased if necessary up to 60 mg daily, dose to be increased gradually, review treatment if inadequate response after 10 weeks; max. 60 mg per day Elderly: 20 mg daily as a single or divided dose, increased if necessary up to 40 mg daily, dose to be increased gradually, review treatment if inadequate response after 10 weeks, usual max. dose is 40 mg daily but doses up to 60 mg daily can be used. Children 7 yr: Initially 10 mg per day, increase to 20 mg per day after 2 weeks, consider additional dose increases after several more week if clinical improvement not observed. Usual: 20-40 mg per day, max: 60 mg per day. *Panic disorder:* Adults: Initial: 10 mg per day, increase to 20 mg per day after 1 week. May be increased further after several weeks if needed; Max: 60 mg per day. *Premenstrual dysphoric disorder:* Adults: 20 mg daily up to 6 months. Max: 60 mg/day. Intermittent treatment: Initially 20 mg daily; start 14 day before menses onset through 1st full day of menses upto 3 months. Max: 60 mg/day.

⛔ Contraindications

Severe renal failure.

⚠️ Precautions & Warnings

Epilepsy, liver and renal impairment, cardiac disease.

🔄 Drug Interactions

MAOls, tryptophan, lithium.

⚠️ Adverse Reactions / Side Effects

Alopecia, euphoria, chills, changes in blood sugar, confusion, diarrhoea, dysphagia, dyspnea, flushing, haemorrhage, hepatitis, hypotension, impaired concentration, malaise, neuroleptic malignant syndrome-like event, palpitation, pharyngitis, priapism, pulmonary fibrosis, pulmonary inflammation, sleep disturbances, taste disturbance, toxic epidermal necrolysis, urinary frequency, vasodilatation

🤰 Pregnancy & Lactation Safety

Pregnancy Risk:
Avoid unless potential benefit outweighs risk
Lactation / Breastfeeding:
Contraindicated, avoid

📚 Official Regulatory & Clinical References

  • Drug Regulatory Authority of Pakistan (DRAP): Drug Registration, S.R.O. Price Gazettes & National Essential Medicines List (NEML).
  • World Health Organization (WHO): Collaborating Centre for Drug Statistics Methodology (ATC/DDD Index).
  • Formulary Standards: British National Formulary (BNF) & Pakistan National Formulary (PNF) guidelines.

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