CLINICAL USE

Antidepressant

DOSE IN NORMAL RENAL FUNCTION

4–5 mg twice daily; maximum 12 mg daily

PHARMACOKINETICS

  • Molecular weight                           :409.5 (as mesilate)
  • %Protein binding                           :97 (92% in elderly)
  • %Excreted unchanged in urine     : 10
  • Volume of distribution (L/kg)       :26–63 litres
  • half-life – normal/ESRD (hrs)      :13/26

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50     : Dose as in normal renal function
  • 10 to 20     : 2 mg twice daily and adjust according to response
  • <10           : 2 mg twice daily and adjust according to response

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD                :Unknown dialysability. Dose as in GFR <10 mL/min
  • HD                     :Unknown dialysability. Dose as in GFR <10 mL/min
  • HDF/high flux   :Unknown dialysability. Dose as in GFR <10 mL/min
  • CAV/VVHD      :Unknown dialysability. Dose as in GFR 10 to 20 mL/min

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs

  • Antibacterials: avoid concomitant use with macrolides and linezolid
  • Antidepressants: risk of increased toxicity with concomitant use with MAOI’s; avoid concomitant use with fluvoxamine
  • Antifungals: avoid concomitant use with imidazoles and triazoles
  • Antimalarials: avoid concomitant use with artemether with lumefantrine
  • Ciclosporin: use with caution as high concentrations of reboxetine inhibit CYP3A4 and CYP2D6
  • Sibutramine: increased risk of CNS toxicity – avoid concomitant use

    ADMINISTRATION

    Reconstition

    –

    Route

    Oral

    Rate of Administration

    –

    Comments

    –.

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