Nefazodone HCl
A to Z Drug Facts
Nefazodone HCl |
(neff-AZE-oh-dohn HIGH-droe-KLOR-ide) |
Serzone |
Tablets |
50 mg |
Tablets |
100 mg |
Tablets |
150 mg |
Tablets |
200 mg |
Tablets |
250 mg |
Class: Antidepressant |
Action Undetermined; inhibits neuronal uptake of serotonin and norepinephrine; antagonizes alpha1-adrenergic receptors.
Indications Treatment of depression.
Contraindications Coadministration with carbamazepine, cisapride, or pimozide; hypersensitivity to nefazodone or other phenylpiperazine antidepressants (eg, trazodone).
ADULTS: PO 100 mg bid initially, increase by 100 to 200 mg increments q wk (max, 600 mg/day).
Elderly/Debilitated patients: PO 50 mg bid initially, increase by 100 mg increments q wk (max, 600 mg/day).
Benzodiazepines: Increased plasma concentrations and effects of alprazolam and triazolam.
Buspirone: Elevated buspirone concentrations, decreased buspirone metabolite plasma concentrations.
Carbamazepine: Elevated serum carbamazepine concentrations with possible increase in side effects may occur.
Cisapride: Increased cisapride plasma concentrations with cardiotoxicity may occur.
Digoxin: Increased plasma levels of digoxin.
Haloperidol: Decreased haloperidol clearance; may need to adjust haloperidol dose.
HMG-CoA Reductase Inhibitors (eg, Simvastatin): The risk of rhabdomyolysis occurrence may be increased.
MAOI: Do not use nefazodone concurrently or within 14 days of discontinuing a MAOI; do not start MAOI within 1 wk of stopping nefazodone.
Pimozide: Increased plasma concentrations of pimozide may occur associated with QT prolongation and rare cases of serious cardiovascular adverse events, including death, principally caused by ventricular tachycardia of the torsades de pointes type.
Propranolol: Nefazodone may decrease propranolol serum concentration; propranolol may interfere with nefazodone metabolism.
St. Johns Wort: Increased sedative-hypnotic effects may occur.
Sibutramine, Sumatriptan, Trazodone: A serotonin syndrome including irritability, increased muscle tone, shivering, myoclonus, and altered consciousness may occur.
Lab Test Interferences None well documented.
CARDIOVASCULAR: Hypotension; orthostatic hypotension; peripheral edema; sinus bradycardia; postural hypotension. CNS: Headache; somnolence; dizziness; insomnia; lightheadedness; confusion; memory impairment; paresthesia; abnormal dreams; decreased concentration; ataxia; incoordination; psychomotor retardation; tremor; hypertonia; decreased libido; vasodilation. DERMATOLOGIC: Pruritus; rash. EENT: Blurred vision; abnormal vision; visual field defects; eye pain; tinnitus; abnormal taste. GI: Dry mouth; nausea; constipation; dyspepsia; diarrhea; increased appetite; vomiting. GU: Urinary frequency; urinary tract infection; urinary retention; vaginitis; breast pain; impotence. HEMATOLOGIC: Decreased hematocrit. RESPIRATORY: Pharyngitis; cough. OTHER: Asthenia; flu syndrome; chills; fever; neck rigidity; arthralgia; thirst.
Pregnancy: Category C. Lactation: Undetermined. Children: Safety and efficacy in children less than 18 yr not established. Elderly: Initiate treatment at half the usual dose. Dosage range same as younger patients. Bradycardia: Sinus bradycardia reported in 1.5% of patients; use with caution in patients with recent MI or unstable heart disease. Hepatotoxicity: Life-threatening hepatic failure may occur; do not initiate nefazodone therapy in patients with active liver disease or elevated baseline transaminases. Mania/Hypomania: May activate mania/hypomania; use with caution in patients with history of mania. Postural Hypotension: Use with caution in patients with known cardiovascular or cerebrovascular disease that could be exacerbated by hypotension (eg, history of MI, angina, ischemic stroke) and conditions that would predispose to hypotension (eg, dehydration, hypovolemia, treatment with antihypertensive medications). Seizures: Rare cases of petit mal and grand mal seizures reported. Suicide: Closely monitor patients at risk, and do not give them access to excessive quantities. Priapism: Priapism (prolonged, painful, inappropriate penile erection) has been reported with closely related antidepressants. Discontinuation of therapy is necessary. Visual Disturbances: Visual disturbances, including blurred vision, scotoma, and visual trails reported.
PATIENT CARE CONSIDERATIONS |
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Copyright © 2003 Facts and Comparisons
David S. Tatro
A to Z Drug Facts