CLINICAL USE

Antidepressant

DOSE IN NORMAL RENAL FUNCTION

Depression: 100–300 mg daily; maximum 600 mg daily in divided doses for hospital patients Anxiety: 75–300 mg daily

PHARMACOKINETICS

  • Molecular weight                           : 408.3
  • %Protein binding                           : 89–95
  • %Excreted unchanged in urine     : <5
  • Volume of distribution (L/kg)       : 1–2
  • half-life – normal/ESRD (hrs)      : 5–13/ –

    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. Start with small doses and increase gradually
  • <10           : Start with small doses and increase gradually

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD                : Unlikely to be dialysed. Dose as in GFR <10 mL/min
  • HD                     : Unlikely to be dialysed. 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

  • Alcohol: increased sedative effects
  • Antidepressants: avoid concomitant use with MAOIs and moclobemide
  • Anti-epileptics: antagonism of anticonvulsant effect
  • Antimalarials: manufacturer advises avoid concomitant use with artemether and lumefantrine
  • Sibutramine: increased risk of CNS toxicity – avoid concomitant use

    ADMINISTRATION

    Reconstition

    –

    Route

    Oral

    Rate of Administration

    –

    Comments

    –

    OTHER INFORMATION

    Use lower doses in elderly patients The majority of a dose (75%) is excreted by the kidney, mainly as metabolites

    • Tags:

    Related News

    ffddfd

    Hyperlipidemia