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Profession Email
Profession Email
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Indications/Uses
Depression.
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Dosage/Direction for Use
Adult: PO Initial: 75 mg/day as a single or in divided doses at night, may increase to 150 mg/day. In severe cases, may increase up to 225 mg/day.
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Administration
May be taken with or without food.
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Contraindications
Manic phase of bipolar disorder, arrhythmias, heart block, immediate recovery period after MI. Hepatic impairment. Concomitant admin w/ MAOIs or w/in 14 days after discontinuation.
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Special Precautions
Patient w/ history of bipolar disorder and psychosis. Patient w/ severe CV disease including heart failure, conduction disorders or cardiac arrhythmia; risk factors for QTc prolongation/TdP including congenital long QT syndrome; significant risk of suicide; glaucoma, urinary retention, prostatic hypertrophy. Avoid abrupt withdrawal. Elderly. Pregnancy and lactation. Patient Counselling This drug may cause drowsiness, if affected do not drive or operate machinery. Monitoring Parameters Closely monitor for clinical worsening and suicidality (esp at the beginning of the treatment and dose change). Perform ECG prior to treatment. Monitor CV and ECG. Examine eyes regularly during prolonged treatment.
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Adverse Reactions
Drowsiness, dizziness, tremor, confusional states, paraesthesia, EEG patterns alterations, disorientation; dry mouth, urinary retention, sweating; hypotension, postural hypotension, tachycardia, arrhythmias (including ventricular tachycardia, ventricular fibrillation and torsades de pointes), conduction defects, palpitations; increased or decreased libido; constipation, nausea, vomiting; blurred vision. Rarely, dysarthria, extrapyramidal symptoms, paralytic ileus, tremor, neuroleptic malignant syndrome, precipitation of angle-closure glaucoma.
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Drug Interactions
Increased risk of ventricular arrhythmias w/ drugs that prolong QT interval. May potentiate sedative effect w/ barbiturates, tranquilisers, CNS depressants. May block antihypertensive effect of guanethidine and other adrenergic neurone blocking drugs. May potentiate effects of anticholinergics, antihistamines, sympathomimetics. Increased risk of postural hypotension w/ diuretics. May antagonise effect of antiepileptics.
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CIMS Class
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ATC Classification
N06AA16 - dosulepin ; Belongs to the class of non-selective monoamine reuptake inhibitors. Used in the management of depression.
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