CLINICAL USE


Reversible MAOI:Depression Social phobia

DOSE IN NORMAL RENAL FUNCTION

Depression: 150–600 mg daily in divided dosesSocial phobia: 300 mg twice daily

PHARMACOKINETICS

  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :268.7
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :50
  • %Excreted unchanged in urine &nbsp &nbsp : <1

  • Volume of distribution (L/kg) &nbsp &nbsp &nbsp :1

  • half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :2–4/unchanged

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
  • 10 to 20 &nbsp &nbsp : Dose as in normal renal function
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Dose as in normal renal function

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Likely dialysability. Dose as in normal renal function

  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Likely dialysability. Dose as in normal renal function
  • HDF/high flux &nbsp :Likely dialysability. Dose as in normal renal function
  • CAV/VVHD &nbsp &nbsp &nbsp:Likely dialysability. Dose as in normal renal function

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs
  • Analgesics: possible CNS excitation or depression with dextromethorphan or pethidine – avoid concomitant use; possible CNS excitation or depression with opioid analgesics
  • Antidepressants: avoid concomitant use; possible increased serotonergic effects with duloxetine
  • Antimalarials: avoid concomitant use with artemether/lumefantrineBupropion: avoid concomitant use
  • Dopaminergics: use with caution with entacapone; increased side effects with levodopa; avoid concomitant use with selegiline5HT 1 agonists: increased CNS toxicity with rizatriptan and sumatriptan – avoid concomitant use; increased CNS toxicity with zolmitriptan – reduce zolmitriptan dose
  • Sibutramine: increased CNS toxicity – avoid concomitant use
  • Sympathomimetics: risk of hypertensive crisis

    ADMINISTRATION

    Reconstition

    –

    Route

    Oral

    Rate of Administration

    –

    Comments

    Take after food

    OTHER INFORMATION

    Hyponatraemia has been reported (especially in elderly patients) due to inappropriate secretion of antidiuretic hormone.
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