Applies to the following strength(s): 5 mg ; 10 mg ; 20 mg
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Usual Adult Dose for:
Additional dosage information:
Usual Adult Dose for Depression
Initial dose: 10 mg orally once a day
Maintenance dose: 20 mg orally once a day
Maximum dose: 20 mg orally once a day
Use: Treatment of major depressive disorder (MDD)
Renal Dose Adjustments
-Mild to end stage renal disease: No adjustment recommended
Liver Dose Adjustments
-Mild to moderate hepatic impairment: No adjustment recommended
-Severe hepatic impairment: Not recommended
-Patients who do not tolerate higher doses may be maintained on 5 mg orally once a day.
-To avoid discontinuation due to adverse reactions such as headache and muscle tension, the dose should be decreased to 10 mg/day for one week before full discontinuation of 15 mg/day or 20 mg/day.
-The maximum recommended dose in patients who are poor CYP450 2D6 metabolizers is 10 mg per day.
-The dose should be reduced by one-half in patients taking a CYP450 2D6 strong inhibitor (e.g., bupropion, fluoxetine, paroxetine, or quinidine) concomitantly. When the CYP450 2D6 inhibitor is discontinued, the dose may be increased to the original level.
-The dose should be increased when a strong CYP450 inducer (e.g., rifampin, carbamazepine, or phenytoin) is coadministered for greater than 14 days. This maximum dose should not exceed 3 times the original dose. When the inducer is discontinued, the dose of this drug should be reduced to the original level within 14 days.
SUICIDAL THOUGHTS AND BEHAVIORS
-Antidepressants increased the risk of suicidal thoughts and behavior in children, adolescents, and young adults in short-term studies. These studies did not show an increase in the risk of suicidal thoughts and behavior with antidepressant use in patients over age 24; there was a trend toward reduced risk with antidepressant use in patients aged 65 and older.
-In patients of all ages who are started on antidepressant therapy, monitor closely for worsening, and for emergence of suicidal thoughts and behaviors. Advise families and caregivers of the need for close observation and communication with the prescriber.
-This drug has not been evaluated for use in pediatric patients.
Safety and efficacy have not been established in patients younger than 18 years.
Consult WARNINGS section for additional precautions.
Data not available
-Administer without regard to meals.
-Acute episodes of major depression should be followed by several months or longer of sustained pharmacologic treatment.
-Hematologic: Bleeding events
-Nervous system: Serotonin syndrome
-Psychiatric: Emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior
-Patients should be cautioned about operating hazardous machinery, including automobiles, until they are reasonably certain that treatment does not affect their ability to perform these activities.
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Other brands: Trintellix