📋 Indications & Clinical Dosage
*Major depression:*
Adult: Initially 15-30 mg daily for 2-4 weeks, dose to be taken at bedtime, then adjusted according to response to up to 45 mg once daily, alternatively up to 45 mg daily in 2 divided doses.
⚠️ Precautions & Warnings
Hepatic or renal impairment, cardiac disorders, diabetes mellitus, elderly, history of bipolar depression, history of seizures, history of urinary retention, hypotension, psychoses, susceptibility to angle-closure glaucoma or increased intra-ocular pressure, organic brain syndrome, diabetes, angina, recent MI, prostatic hypertrophy. Monitor patients for suicidal ideation. Discontinue if jaundice occurs. Dose increases may be detrimental in patients who develop akathisia. Withdraw gradually.
🔄 Drug Interactions
MAOIs, SSR1s, SNRIs, tryptophan, triptans, tramadol, linezolid, lithium, St. Johns Wort, and other serotonergic agents. CNS depressants, alcohol, protease inhibitors, erythromycin, nefazodone, cimetidine, warfarin, Carbamazepine, phenytoin and other CYP3A4 inducers, Ketoconazole, other azole antifungals and other potent CYP3A4 inhibitors
⚠️ Adverse Reactions / Side Effects
Agitation, anxiety, arthralgia, blood disorders, confusion, convulsions, dizziness, drowsiness, dry mouth, fatigue, headache, increased appetite, insomnia, myalgia, oedema, postural hypotension, tremor, weight changes, hallucinations, mania, movement disorders, syncope, dysarthria, hypersalivation, hyponatraemia, inappropriate secretion of antidiuretic hormone, sedation during initial treatment. Rare: Aggression, myoclonus, pancreatitis, angle-closure glaucoma, Stevens-Johnson syndrome, suicidal behavior, toxic epidermal necrolysis
🤰 Pregnancy & Lactation Safety
Pregnancy Risk:
Contraindicated
Lactation / Breastfeeding:
Contraindicated