Pregnancy Risk Category C
How supplied
Tablets: 50 mg, 100 mg, 150 mg, 300 mg
Action
Unknown. Inhibits neuronal uptake of serotonin (5-HT2) and norepinephrine; it also occupies serotonin and alpha1-adrenergic receptors in the CNS.
Indications & dosage
Depression--
Adults: initially, 200 mg/day P.O. in two divided doses. Dosage increased in increments of 100 to 200 mg/day at intervals of no less than 1 week, p.r.n. Usual dosage range is 300 to 600 mg/day.
Elderly: initially, 100 mg/day P.O. in two divided doses.
Adjust-a-dose: For debilitated patients, initially 100 mg/day P.O. in two divided doses.
Adverse reactions
CNS: headache, somnolence, dizziness, asthenia, insomnia, light-headedness, confusion, memory impairment, paresthesia, vasodilation, abnormal dreams, decreased concentration, ataxia, incoordination, psychomotor retardation, tremor, hypertonia.
CV: orthostatic hypotension, hypotension, peripheral edema.
EENT: blurred vision, abnormal vision, tinnitus, visual field defect, pharyngitis.
GI: dry mouth, nausea, constipation, taste perversion, dyspepsia, diarrhea, increased appetite, vomiting.
GU: urinary frequency, urinary tract infection, urine retention, vaginitis.
Musculoskeletal: neck rigidity, arthralgia.
Respiratory: cough.
Skin: pruritus, rash.
Other: infection, flulike syndrome, chills, fever, breast pain, thirst.
Interactions
Drug-drug. Alprazolam, triazolam: administration with nefazodone potentiates effects of these drugs. Don't administer concurrently. However, if necessary, dosage of alprazolam and triazolam may need to be greatly reduced.
CNS drugs: may alter CNS activity. Use together cautiously.
Digoxin: may increase digoxin level. Use together cautiously and monitor digoxin levels.
MAO inhibitors: may cause severe excitation, hyperpyrexia, seizures, delirium, or coma. Avoid concomitant use.
Other highly protein-bound drugs: may increase incidence and severity of adverse reactions. Monitor patient closely.
Drug-lifestyle. Alcohol use: enhanced CNS depression. Avoid concomitant use.
Effects on diagnostic tests
None reported.
Contraindications
Contraindicated in patients with hypersensitivity to drug or other phenylpiperazine antidepressants; also contraindicated within 14 days of MAO inhibitor therapy.
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