nefazodone

Pronunciation

Generic Name: nefazodone (ne FAZ oh done)
Brand Name: Serzone

What is nefazodone?

Nefazodone is an antidepressant. It is used to treat depression, including major depressive disorder.

Nefazodone is not chemically similar to other groups of antidepressants, such as selective serotonin reuptake inhibitors or "SSRIs", tricyclic antidepressants, or monoamine oxidase inhibitors or "MAOIs."

Nefazodone may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about nefazodone?

Do not take nefazodone together with carbamazepine (Tegretol), cisapride (Propulsid), pimozide (Orap), or an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), rasagiline (Azilect), or selegiline (Eldepryl, Emsam).

There are many other medicines that can interact with nefazodone. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.

Slideshow: How to Manage Antidepressant Side Effects

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

What should I discuss with my healthcare provider before taking nefazodone?

You should not take this medication if you are allergic to nefazodone or trazodone (Desyrel), or if you have ever had liver problems caused by taking nefazodone.

Do not take nefazodone if you are using any of the following drugs:

  • carbamazepine (Tegretol);

  • cisapride (Propulsid);

  • pimozide (Orap); or

  • an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), rasagiline (Azilect), or selegiline (Eldepryl, Emsam).

Serious and sometimes fatal reactions can occur when these medicines are taken with nefazodone. You must wait at least 14 days after stopping an MAO inhibitor before you can take nefazodone. You must wait 7 days after stopping nefazodone before you can take an MAOI.

If you have any of these other conditions, you may need a dose adjustment or special tests to safely take nefazodone:

  • liver disease (especially cirrhosis);

  • heart disease or recent heart attack;

  • bipolar disorder (manic depression);

  • epilepsy or other seizure disorder; or

  • a history of suicidal thoughts or actions.

You may have thoughts about suicide while taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

FDA pregnancy category C. It is not known whether nefazodone is harmful to an unborn baby. Before taking this medication, tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether nefazodone passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take nefazodone?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Your doctor may occasionally change your dose to make sure you get the best results from the medication.

You may take nefazodone with or without food.

If you need to have any type of surgery, tell the surgeon ahead of time that you are taking nefazodone. You may need to stop using the medicine for a short time.

It may take several weeks of using this medicine before your symptoms improve. For best results, keep using the medication as directed.

Store nefazodone at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and take the next one as directed. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have taken too much of this medication. Overdose symptoms may include nausea, vomiting, extreme drowsiness, or seizure (convulsions).

What should I avoid while taking nefazodone?

Avoid drinking alcohol while you are taking nefazodone.

Nefazodone can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Nefazodone side effects

Get emergency medical help if you have any of these signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Stop taking nefazodone and call your doctor at once if you have a serious side effect such as:

  • nausea, stomach pain, loss of appetite, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

  • confusion, hallucinations, unusual thoughts or behavior;

  • seizure (convulsions);

  • penis erection that is painful or lasts 4 hours or longer;

  • fever, chills, body aches, flu symptoms; or

  • feeling like you might pass out.

Less serious side effects may include:

  • mild nausea, diarrhea, constipation;

  • dizziness, drowsiness, weakness;

  • sleep problems (insomnia);

  • dry mouth, sore throat;

  • vision problems;

  • headache; or

  • increased appetite.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Nefazodone dosing information

Usual Adult Dose for Depression:

Nefazodone sold under the trade name of Serzone was voluntarily withdrawn from the U.S. market in June 2004. The manufacturer blamed a decline in sales as the reason for the withdrawal of the drug. However, some feel the withdrawal of this drug may have actually been because nefazodone has been linked to dozens of cases of liver failure and injury, including at least 20 deaths. Canadian regulators had banned the drug in the fall of 2003 because of the liver risk associated with it. Serzone has also been pulled off the market in many other countries and the manufacturer had been under mounting pressure from lawsuits in the U.S. However, generic versions of nefazodone are still available in the U.S.

Initial dose: 100 mg orally twice a day.
Maintenance dose: 150 to 300 mg orally twice a day. The dose may be increased in 100 to 200 mg increments at intervals of no less than 1 week.

Usual Pediatric Dose for Depression:

Nefazodone sold under the trade name of Serzone was voluntarily withdrawn from the U.S. market in June 2004. The manufacturer blamed a decline in sales as the reason for the withdrawal of the drug. However, some feel the withdrawal of this drug may have actually been because nefazodone has been linked to dozens of cases of liver failure and injury, including at least 20 deaths. Canadian regulators had banned the drug in the fall of 2003 because of the liver risk associated with it. Serzone has also been pulled off the market in many other countries and the manufacturer had been under mounting pressure from lawsuits in the U.S. However, generic versions of nefazodone are still available in the U.S.

<7 years: Safety and efficacy have not been established.
7 to 12 years:
Initial dose: 50 mg orally twice a day (investigational).
Maintenance dose: 100 to 150 mg orally twice a day. The dose may be increased in 50 mg increments at intervals of no less than 1 week.

12 to 18 years:
Initial dose: 50 mg orally twice a day (investigational).
Maintenance dose: 100 to 300 mg orally twice a day. The dose may be increased in 50 to 100 mg increments at intervals of no less than 1 week.

What other drugs will affect nefazodone?

Cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures or anxiety may add to the side effects of nefazodone. Tell your doctor if you regularly use any of these medicines, or any other antidepressants.

Tell your doctor about all other medications you use, especially:

  • buspirone (BuSpar);

  • cyclosporine (Neoral, Sandimmune, Gengraf);

  • digoxin (digitalis, Lanoxin);

  • haloperidol (Haldol);

  • phenytoin (Dilantin);

  • propranolol (Inderal);

  • tacrolimus (Prograf);

  • triazolam (Halcion);

  • a blood thinner such as warfarin (Coumadin);

  • cholesterol-lowering medicines such as atorvastatin (Lipitor), simvastatin (Zocor), or lovastatin (Mevacor); or

  • any other antidepressant such as desipramine (Norpramin) or fluoxetine (Prozac).

This list is not complete and there may be other drugs that can interact with nefazodone. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about nefazodone.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 7.02. Revision Date: 2010-12-15, 5:01:39 PM.

Hide
(web5)