📋 Indications & Clinical Dosage
*Mild to moderate mixed anxiety, depression:*
Adults: 1 tab two to three times daily for max 3 months. Children: Not recommended.
⛔ Contraindications
Severe cardiac insufficiency, comatose states, severe depression, pheochromocytoma, renal or hepatic failure, severe hepatic impairment, marked cerebral atherosclerosis, , blood dyscrasias, heart block, arrhythmias, mania, porphyria.
⚠️ Precautions & Warnings
Epilepsy, liver, respiratory or cardiac disease, cardiac arrhythmias, thyrotoxicosis, elderly, glaucoma, hypothyroidism, myasthenia gravis, prostatic hypertrophy, Parkinsons disease; reduce dose or use anti-Parkinsonian drugs in patients showing extra-pyramidal reactions, concurrent ECT, hyperthyroidism, psychosis, suicidal tendencies, anaesthesia. Withdraw gradually.
🔄 Drug Interactions
Adrenaline, alcohol, barbiturates, CNS depressants, other antipsychotics, anticholinergics, antacids, do-paminergics, lithium, oral hypoglycaemics, antihypertensives, anticonvulsants, drugs that prolong the QT interval (e.g. anti-arrhythmics), sibutramine, metoclopramide, sympathomimetics, carbamazepine, barbiturates, cimetidine.
⚠️ Adverse Reactions / Side Effects
Acute dystonias and dyskinesias, akathisia, hyperglycaemia, Parkinsonism, drowsiness, insomnia, agitation, tachycardia, leucopenia, hyperprolactinaemia, arrhythmias, ECG changes, hypotension, anticholinergic effects (e.g.. dry month, blurred vision), respiratory depression, nasal stuffiness, rash, photosensitivity, impaired tem-perature regulation, male sexual dysfunction. Rarely, agranulocytosis, tardive dyskinesia, jaundice, neuroleptic malignant syndrome, pigmentary retinopathy.
🤰 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.