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Indications and Dosage
Oral
Chronic psychosis Adult: Initially, 0.5 mg daily. Adjust dosage upward or downward according to response. Dosage range: 0.1-1 mg daily. Oral Hypertension Adult: Initially, up to 0.5 mg daily for 1-2 wk, subsequently reduced to the lowest dose necessary to maintain response. Maintenance: 0.1-0.25 mg daily. Max: 0.5 mg daily.
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Administration
Should be taken with food.
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Contraindications
Active peptic ulcer or ulcerative colitis; history of mental depression; phaeochromocytoma, Parkinson’s disease. Patient receiving electroconvulsive therapy (ECT).
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Special Precautions
Patient w/ MI, cardiac arrhythmias, gallstones, epilepsy, allergic conditions (e.g. bronchial asthma). Hypertensive patient w/ renal insufficiency. Pregnancy and lactation.
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Adverse Reactions
Nasal congestion, headache, CNS symptoms including depression, drowsiness, dizziness, lethargy, nightmares; GI disturbance including diarrhoea, abdominal cramps, increased gastric acid secretion; flushing, bradycardia, extrapyramidal effects, hypotension, convulsion, breast engorgement, galactorrhoea, gynaecomastia, increased prolactin concentrations, decreased libido, impotence, Na retention, oedema, decreased or increased appetite, wt gain, miosis, dry mouth, sialorrhoea, dysuria, rashes, pruritus, thrombocytopenic purpura.
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Monitoring Parameters
Asses/monitor BP and cardiac status prior to starting therapy, during first doses, when changing dose and regularly, thereafter.
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Overdosage
Symptoms: Impaired consciousness ranging from drowsiness to coma, flushing, conjunctival injection, pupillary constriction, hypotension, hypothermia, central resp depresson, bradycardia, increased salivary and gastric secretion, diarrhoea. Management: Symptomatic and supportive treatment. Administer activated charcoal w/in 1 hr of ingestion. Place patient in supine position w/ feet raised for severe hypotension or give direct-acting sympathomimetics.
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Drug Interactions
Enhanced hypotensive effects w/ thiazide diuretics and other antihypertensives. May cause excitation and HTN in patients receiving MAOIs. Risk of cardiac arrhythmias w/ digitalis or quinidine. May enhance the effects of CNS depressants. May inhibit the action of indirect-acting amines (e.g. ephedrine). May prolong the action of direct-acting amines (epinephrine). Decreased antihypertensive effect w/ TCAs.
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Action
Description: Reserpine is an antihypertensive drug that causes depletion of norepinephrine, catecholamine and serotonin stores resulting in a reduction in BP, bradycardia and CNS depression. Decrease in cardiac output and peripheral resistance result in hypotensive effect.
Onset: Antihypertensive: 3-6 days. Duration: 2-6 wk. Pharmacokinetics: Absorption: Absorbed from the GI tract. Bioavailability: 50%. Distribution: Crosses the placenta and blood-brain barrier and enters breast milk. Plasma protein binding: 96%. Metabolism: Extensively metabolised in the liver (>90%). Excretion: Via faeces (approx 60% as unchanged drug) and urine (approx 8% as metabolites). Elimination half-life: Approx 50-100 hr. |
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Chemical Structure
 Source: National Center for Biotechnology Information. PubChem Database. Reserpine, CID=5770, https://pubchem.ncbi.nlm.nih.gov/compound/Reserpine (accessed on Jan. 22, 2020) |
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Storage
Store between 20-25˚C. Protect from moisture.
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MIMS Class
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ATC Classification
C02AA02 - reserpine ; Belongs to the class of rauwolfia alkaloids, centrally-acting antiadrenergic agents. Used in the treatment of hypertension.
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References
Anon. Reserpine. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 23/05/2016. Buckingham R (ed). Reserpine. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 23/05/2016. Reserpine Tablet (Eon Labs, Inc). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 23/05/2016.
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