Adult Initially 40 mg once daily, increase to 80 mg once daily after 1 wk. May consider continuation of 40 mg once daily for some patients. Patient receiving strong CYP3A4 & CYP2D6 inhibitors & those CYP2D6 poor metabolizers 40 mg once daily. Moderate or severe hepatic impairment (Child-Pugh score 7-15) 40 mg once daily.
May prolong QT interval. Avoid use in patients w/ congenital long QT syndrome or w/ arrhythmias associated w/ prolonged QT interval; assess QT interval before increasing the dosage. May cause parkisonism in patients w/ tardive dyskinesia. Reduce dose or discontinue treatment in patients who develop clinically significant parkinson-like signs or symptoms. Not recommended to use concomitantly w/ strong CYP3A4 inducers. Possible somnolence; may impair ability to drive or operate hazardous machinery. Pregnancy. Advise not to breastfeed during treatment & for 5 days after final dose. Ped patients.
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