Major depressive disorder/GAD Initially 75 mg/day as single dose. Moderately depressed outpatients Initially 75 mg/day. New patients adjusting to medication 37.5 mg/day for 4-7 days, increasing to 75 mg/day. Max: 225 mg/day. Dose increases in increments up to 75 mg/day as needed & should be made at interval not <4 days. Social anxiety disorder (social phobia) 75 mg/day. Panic disorder Initially 37.5 mg/day for 7 days. Outpatients w/ panic disorder Initially 37.5 mg/day for 7 days followed by 75 mg/day & subsequent wkly dose increases of 75 mg/day to a max of 225 mg/day. Dose increases should be up to 75 mg/day as needed & should be made at intervals not <7 days.
Should be taken with food: Take at approx same time each day. Swallow whole, do not divide/chew/crush/place in water. May open cap & sprinkle contents on a spoonful of applesauce and swallow immediately w/o chewing followed by a glass of water.
Contraindications
Hypersensitivity. Concomitant use w/ MAOIs. Increased risk of serotonin syndrome w/ linezolid or IV methylene blue.
Clinical worsening of depression, suicidality & unusual changes in behavior especially during initial few mth of course drug therapy or at times of dose changes. Not approved use for treating bipolar depression. Development of serotonin syndrome due to concomitant use w/ serotonergic drugs. Angle-closure glaucoma. Sustained HTN. Monitor for discontinuation symptoms due to abrupt discontinuation & dose changes. Insomnia & nervousness; changes in wt; hyponatremia; ILD & eosinophilic pneumonia. Patients w/ history of mania; hyperthyroidism, heart failure or recent MI. Co-administration w/ wt loss agents is not recommended. Abnormal bleeding in concomitant use w/ NSAIDS, aspirin. Renal impairment (GFR 10-70 mL/min) or liver cirrhosis. Pregnancy during 3rd trimester. Lactation. Wt gain for childn <12 yr. Childn. Elderly.
Sign Out
