Depression including depression w/ associated anxiety. Generalized anxiety disorder (GAD) including long-term treatment. Social anxiety disorder (SAD or social phobia), panic disorder including prevention of relapse. Prevention of relapse & recurrence of depression.
Major depressive disorder Initially 75 mg once daily, may be increased in 75-mg increments at ≥4 days interval. Dose can be titrated up to 225 mg daily in moderate depression & 375 mg daily in severe depression. GAD Initially 75 mg once daily, may be increased up to max: 225 mg daily. SAD Initially 75 mg once daily. Panic disorder Initially 37.5 mg daily for 7 days, then increased to 75 mg daily. May be further increased up to max: 225 mg daily.
Should be taken with food: Take at the same time each day. Swallow whole, do not chew/crush/divide/dissolve. Cap may be carefully opened & entire contents sprinkled on a spoonful of applesauce. Swallow drug/food mixt w/o chewing immediately after prep & followed w/ glass of water.
Contraindications
Hypersensitivity. Concomitant use or w/in at least 14 days after discontinuation of MAOIs. Discontinue use for at least 7 days before initiating MAOI.
Monitor patients for suicide/suicidal thoughts or clinical worsening. Increased risk of bone fractures. NMS-like reactions; sexual dysfunction; hyponatermia; mydriasis; risk factors for QTc prolongation; history of convulsions or bipolar disorder or aggression; patients predisposed to bleeding. Abuse & dependence. Monitor BP, control preexisting HTN in BP or heart rate compromised patients. Measure serum cholesterol in long-term use. Avoid abrupt discontinuation. Not recommended in concomitant use w/ serotonin precursors; wt loss agents. May affect ability to drive & use machines. Renal or hepatic impairment. Pregnancy & lactation. Childn & adolescents <18 yr. Elderly.
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