Moclobemide

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 :268.7

%Protein binding :50

%Excreted unchanged in urine : <1

Volume of distribution (L/kg) :1

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

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Likely dialysability. Dose as in normal renal function

HD :Likely dialysability. Dose as in normal renal function

HDF/high flux :Likely dialysability. Dose as in normal renal function

CAV/VVHD :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

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Route

Oral

Rate of Administration

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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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