Moclobemide


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : PO Depression Initial: 300 mg/day in divided doses; up to 600 mg/day according to response. Maintenance: 150 mg/day. Social anxiety disorder Initial:300 mg/day, up to 600 mg/day in 2 divided doses after 3 days. Continue for 8-12 wk.
Dosage Details
Oral
Depression
Adult: Initially, 300 mg daily in divided doses; increase up to 600 mg daily according to patient's response. Maintenance: 150 mg daily.

Oral
Social anxiety disorder
Adult: Initially, 300 mg daily; increase to 600 mg daily in 2 divided doses after 3 days. Continue for 8-12 wk.
Hepatic Impairment
Reduce to ½ or 1/3 of recommended dose.
Administration
Should be taken with food. Take immediately after meals.
Contraindications
Acute confusional states and phaeochromocytoma.
Special Precautions
Excited or agitated patients; bipolar disorders; hepatic impairment; thyrotoxicosis. Early antidepressant therapy; close monitoring particularly during periods of dosage adjustments. May impair ability to drive or operate machinery. Pregnancy and lactation. Withdrawal should be gradual.
Adverse Reactions
Tachycardia, hypotension, dizziness, headache, drowsiness, sleep disturbances, agitation, nervousness, sedation, somnolence, anxiety, increased appetite, xerostomia, nausea, constipation, abdominal pain, diarrhoea, vomiting, weakness, blurred vision, increased sweating, increased transaminases, elevated creatine kinase (CK) and creatine phosphokinase (CPK).
Potentially Fatal: Hypertensive crisis.
Overdosage
Agitation, amnesia, convulsions, disorientation, drowsiness, hypertension, nausea, reduced reflexes, slurred speech, vomiting. Management: Symptomatic and supportive care; there is no antidote.
Drug Interactions
Increased plasma concentrations with cimetidine. Behavioural and neurologic syndromes with tryptophan. Excessive sedation and acute hypotension with CNS depressants (opiates or others analgesics, barbiturates or other sedatives, anaesthetics or alcohol). Marked hypotensive effects with diuretics and hypotensive agents. Worsening of depression and/or suicidality with antidepressants.
Potentially Fatal: Serotonin syndrome with sympathomimetic agents (e.g. amphetamines, dopamine, epinephrine, norepinephrine, methylphenidate) or related substances (e.g. methyldopa, levodopa, L-tryptophan, L-tyrosine, phenylalanine), MAOI, meperidine, TCA, serotonergic drugs (SSRI). Do not use until at least a wk after discontinuation of an SSRI or SSRI-related antidepressant, a TCA or TCA-related, or a non-selective MAOI.
Food Interaction
Avoid large amounts of tyramine-rich food (e.g. certain cheeses, tofu, soybeans, fish, lima beans, coffee) as the pressor effect of tyramine may be potentiated. Avoid ginkgo (may lead to MAOI toxicity). Avoid ephedra, yohimbe (can cause hypertension). Avoid kava (may increase CNS depression).
Action
Description: Moclobemide acts by reversible inhibition of the isoenzyme monoamine oxidase type A and thus preferentially increasing the availability of the neurotransmitters serotonin, epinephrine, and norepinephrine.
Pharmacokinetics:
Absorption: Readily and 98% from the GI tract; peak plasma concentrations within 1 hr (oral).
Distribution: 50% bound to plasma proteins; enters breast milk.
Metabolism: Extensively hepatic by oxidative reactions.
Excretion: Via urine as metabolites (95%); 1-2 hr (elimination half-life).
Storage
Oral:
Depression: Store at 15-30°C.
Social anxiety disorder: Store at 15°C to 30°C.
MIMS Class
Disclaimer: This information is independently developed by MIMS based on Moclobemide from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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