NEFAZODONE

COMMON BRAND NAME(S): Serzone

GENERIC NAME(S): NEFAZODONE HCL

 

Description: Nefazodone, a phenylpiperazine antidepressant

Pharmacokinetics:

Absorption: Rapidly and completely absorbed but absolute bioavailability is variable and low (about 20%). Time to peak plasma concentration: 1 hr. Absorption delayed by food and bioavailability decreased by approx 20% (clinically not significant).

Distribution: Widely distributed including CNS, with small amounts distributed into breast milk. Volume of distribution: 0.22-0.87 L/kg. Protein binding: Extensively bound to human plasma proteins(>99%).

Metabolism: Undergoes extensive 1st pass metabolism to several metabolites, of which hydroxynefazodone and m-chlorophenylpiperazine, are pharmacologically active.

Excretion: Mainly as metabolites via the urine (about 55%) and the faeces (20-30%). Half-life: 2-4 hr.

  • Used for
    • Treatment of depression by aiding in the restoration the balance of neurotransmitters such as serotonin and norepinephrine in the brain.

 

How to use nefazodone

  • Always refer to your doctors instructions before taking this medication. Duration and dosage will be determined by your medical condition and its response to the medication. Make sure to take this mediciation in the prescribed amount and time period even after symptoms disappear. Discontinuing the medication before completion of treatment may cause incomplete treatment of condition. If Symptoms persist, consult your doctor

 

Taken by mouth; With or without food; usually twice a day or as directed by your physician;

    • Studies have shown that a small number of people (especially people younger than 25) may experience worsening depression, other mental/mood symptoms, or suicidal thoughts/attempts. Consult your doctor for more details

     

    Promptly inform your physician if you notice worsening depression/other psychiatric conditions, unusual behavior changes (including possible suicidal thoughts/attempts), or other mental/mood changes (including new/worsening anxiety, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, very rapid speech). Be especially watchful for these symptoms when a new antidepressant is started or when the dose is changed.

      • Minor side effects (if these symptoms persist or worsen, inform your doctor)
        • Dizziness, drowsiness, lightheadedness, nausea, dry mouth, or constipation

       

      • To relieve dry mouth
        • suck on (sugarless) hard candy or ice chips, chew (sugarless) gum, drink water, or use a saliva substitute.

       

      • Serious side effects (inform your doctor immediately)
        • confusion, weakness, fainting, seizures, easy bleeding/bruising, black stools, vomit that looks like coffee grounds, eye pain/swelling/redness, vision changes (such as seeing rainbows around lights at night, blurred vision).
        • For males
          • in the very unlikely event you have a painful or prolonged erection lasting 4 or more hours, stop using this drug and seek immediate medical attention, or permanent problems could occur
        • Rarely caused very serious (possibly fatal) liver disease
          • severe stomach/abdominal pain, unusual tiredness, persistent loss of appetite, dark urine, yellowing eyes/skin, persistent nausea/vomiting

       

      • Severe allergic reactions are rare. Get immediate medical help if you notice the following:

      Rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing

      • Precautions: 
        • Inform your doctor
          • Allergy to the medication or to trazodone or any allergies
          • Medical History of liver disease, personal or family history of psychiatric disorder (e.g., bipolar/manic-depressive disorder), personal or family history of suicide attempts, heart/blood vessel disease (e.g., history of stroke/heart attack), loss of too much body water (dehydration), seizures, intestinal ulcers/bleeding (peptic ulcer disease), personal or family history of glaucoma (angle-closure type), liver disease or abnormal liver function tests

         

        • May cause dizziness or drowsiness
        • Should only be used when there is a clear need during pregnancy as it may harm an unborn baby. If you are planning to be pregnant or think you may be pregnant, discuss the risks and benefits of use with your doctor.

         

        • It is uknown if this drug passes into breast milk. Before breast-feeding, consult your physician.

         

        Interactions:

        Taking multiple drugs may affect how medications work and/or cause unwanted side effects. List down all the medications you are taking and inform your physician and pharmacist. Do not take, discontinue, or alter any dose of medications without prior approval of your physician.

         

        • Products that may interact with this medication include:
          • carbamazepine, eplerenone, ergot alkaloids (such as dihydroergotamine, ergonovine, ergotamine, methylergonovine), ivabradine, lurasidone, pimozide, triazolam, alpha blockers (e.g., terazosin), digoxin, fluoxetine, medications for high blood pressure, other antidepressants (e.g., trazodone, SSRIs such as fluoxetine), other drugs that can cause bleeding/bruising (e.g., anticoagulants such as heparin or warfarin, antiplatelet drugs including NSAIDs such as ibuprofen), buspirone, cyclosporine, dasatinib, domperidone, fentanyl, regorafenib, sunitinib, tacrolimus, “statin” cholesterol drugs (such as simvastatin, lovastatin, atorvastatin), certain benzodiazepines (such as alprazolam, diazepam)

         

        • Avoid taking MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine) for two weeks before, during treatment, and 1 week after treatment with this medication.

         

        • Avoid taking eletriptan within 72 hours of taking this medication.

         

        • Double check the labels on all medications you are currently taking especially cough-and-cold products since they may contain drowsiness-causing components

         

        • Double check all the labels of the medications you are currently taking as many drugs contain pain relievers/fever reducers such as aspirin, NSAIDs such as celecoxib, ibuprofen, ketorolac that may increase your risk of side effects.

        Also report the use of drugs which might increase seizure risk when combined with nefazodone such as isoniazid (INH), phenothiazines (e.g., thioridazine), theophylline, or tricyclic antidepressants (e.g., amitriptyline), among others. Consult your doctor or pharmacist for details.

      • Overdose: If overdose is suspected, contact a poison control center or emergency room immediately. 

        Missed Dose

        If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and As soon as you remember, take a regular dose or if the time of the next dose is near, wait for it before taking another dose and resume your usual schedule. Do not increase the dose to compensate for the missed dose.

         

        Storage

        • Room temperature between 68-77 degrees F (20-25 degrees C)
        • Do not expose to light and moisture
        • Do not store in the bathroom
        • Keep all medications away from pets and children

         

        Brands:

         

        Available Brands:

        Serzone

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