Pregnancy Risk Category B
How supplied
Tablets: 75 mg, 100 mg
Tablets (sustained-release): 100 mg,
150 mg
Action
Unknown. Drug isn't a tricyclic antidepressant (TCA), doesn't inhibit MAO, and is a weak inhibitor of norepinephrine, dopamine, and serotonin reuptake.
Indications & dosage
Depression--
Adults: initially, 100 mg P.O. b.i.d., increased after 3 days to 100 mg P.O. t.i.d. if needed. If no response occurs after several weeks of therapy, dose increased to 150 mg t.i.d. No single dose should exceed 150 mg. For sustained-release tablets, initially, 150 mg P.O. q morning; increased to target dose of 150 mg P.O. b.i.d. as tolerated as early as day 4 of dosing. Maximum dose is 400 mg/day.
Adverse reactions
CNS: headache, seizures, anxiety, confusion, delusions, euphoria, hostility, impaired sleep quality, insomnia, sedation, tremor, akinesia, akathisia, agitation, dizziness, fatigue, syncope.
CV: arrhythmias, hypertension, hypotension, palpitations, tachycardia.
EENT: auditory disturbances, blurred vision.
GI: dry mouth, taste disturbance, increased appetite, constipation, dyspepsia, nausea, vomiting, anorexia, diarrhea.
GU: impotence, menstrual complaints, urinary frequency, urine retention.
Metabolic: weight loss, weight gain.
Musculoskeletal: arthritis.
Skin: pruritus, rash, cutaneous temperature disturbance, excessive diaphoresis.
Other: fever and chills, decreased libido.
Interactions
Drug-drug. Levodopa, phenothiazines, TCAs; recent and rapid withdrawal of benzodiazepines: increased risk of adverse reactions, including seizures. Monitor patient closely.
MAO inhibitors: altered seizure threshold. Avoid concomitant use.
Drug-lifestyle. Alcohol use: altered seizure threshold. Avoid concomitant use.
Effects on diagnostic tests
None reported.
Contraindications
Contraindicated in patients with hypersensitivity to drug, in those who have taken MAO inhibitors within previous 14 days, and in those with seizure disorders or history of bulimia or anorexia nervosa because of a higher incidence of seizures. Don't use with Zyban or other drugs containing bupropion and used for smoking cessation.
Nursing considerations
Patient teaching
*Liquid contains alcohol. **May contain tartrazine. †Canada ‡Australia §U.K. OTCOver the counter
Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE-THREATENING