100–200mg daily in single or divided doses; max 300mg/day. Hospitalize initially if dose is 300mg/day; monitor ECG. Elderly and adolescents: 25–100mg daily; max 150mg/day.
During or within 14 days of MAOIs. Concomitant linezolid or IV methylene blue. Acute post-MI.
Suicidal ideation (monitor). Psychosis. Mania/hypomania. Bipolar disorder. Cardiovascular disease. History of sudden death, cardiac dysrhythmias or conduction disturbances. Urinary retention. Glaucoma. Epilepsy. ECT. Hyperthyroidism. Diabetes. Hepatic or renal dysfunction. Perform leukocyte and differential counts if fever and sore throat develop; discontinue if neutrophil depression occurs. Discontinue before surgery. Write ℞ for smallest practical amount. Elderly. Pregnancy (Cat.C). Nursing mothers.
See Contraindications. Hyperpyretic crisis, convulsions, death with MAOIs. Increased risk of serotonin syndrome with concomitant MAOIs, linezolid, IV methylene blue, triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, St. John's wort; monitor. Potentiates alcohol, anticholinergics, sympathomimetics, benzodiazepines, other CNS depressants. Potentiated by CYP2D6 inhibitors; monitor plasma levels with cimetidine, SSRIs, phenothiazines, type 1C antiarrhythmics (eg, quinidine, propafenone, flecainide). Antagonized by barbiturates, carbamazepine, phenytoin. Paralytic ileus, hyperpyrexia with anticholinergics. Blocks guanethidine. Possible cardiotoxicity with concomitant thyroid medications.
Drowsiness, anticholinergic effects, CNS overstimulation, arrhythmias, extrapyramidal symptoms, hypo- or hypertension, nausea, fatigue, rash, hyperhidrosis, headache, changes in blood sugar, photosensitivity, edema, blood dyscrasias, jaundice.
Tabs 10mg, 25mg, 50mg, 75mg, 100mg—100; 150mg—50