Amoxapine

Indications
 Oral
Depression
Adult: Initially, 50 mg bid-tid, increased gradually up to 100 mg tid. For severely depressed patients in the hospital: Up to 600 mg daily.
Elderly: Initially, 25 mg bid-tid increased as necessary after 5-7 days up to 150 mg daily. Max: 300 mg daily.
Contraindications
 Hypersensitivity, concurrent treatment with MAOIs, recent MI, heart block or other cardiac arrhythmias. Mania, severe liver disease.
Warnings / Precautions
 Recovery after MI, elderly, CVS disease, liver impairment, epilepsy, psychosis, increased intraocular pressure, history of urinary retention, alcohol, pregnancy and lactation; avoid abrupt withdrawal.
Adverse Reactions
 Postural hypotension, tachycardia, conduction disturbances; dry mouth, blurring of vision, constipation, urinary retention, fatigue, dizziness, weakness, tremors, headache, confusion and delirium in elderly, weight gain, tardive dyskinesia; neuroleptic malignant syndrome; sexual disturbances.
Potentially Fatal: Agranulocytosis, thrombocytopenia; cardiac arrhythmias.
Overdose Reactions
 May result in acute renal failure with rhabdomyolysis, coma and seizures.
Drug Interactions
 Reduced serum levels with barbiturates.
Potentially Fatal: Potentiates sedative effect of alcohol. Antiparkinson agents, antipsychotic drugs increase risk of anticholinergic effects. Reduces effect of antihypertensives. Marked hyperpyrexia, convulsions and coma with MAOIs. Potentiates hypertensive effects of sympathomimetics.
See Below for More amoxapine Drug Interactions
Mechanism of Actions
 Amoxapine inhibits the neuronal re-uptake of noradrenaline and serotonin (5-HT2) in the CNS. It also blocks the response of dopamine receptors to dopamine.
Absorption: Readily absorbed from the GI tract (oral).
Distribution: Enters breast milk. Protein-binding: Extensive.
Metabolism: Undergoes hydroxylation; converted to 8-hydroxyamoxapine and 7-hydroxyamoxapine.
Excretion: Urine (as metabolites). Elimination half-life: 30 hr (8-hydroxyamoxapine), 6.5 hr (7-hydroxyamoxapine).
Administration
 May be taken with or without food.
Storage Conditions
 Oral: Store at 15-30°C.
ATC Classification
 N06AA17 - amoxapine ; Belongs to the class of non-selective monoamine reuptake inhibitors. Used in the management of depression.
Storage
 Oral: Store at 15-30°C.
Available As
  • Amoxapine 100 mg
  • Amoxapine 50 mg

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