Moclobemide

Indications
Oral
Depression
Adult: Initially, 300 mg daily in divided doses; increase up to 600 mg daily according to patient's response. Maintenance: 150 mg daily.
Hepatic impairment: Reduce to ½ or 1/3 of recommended dose.
Oral
Social anxiety disorder
Adult: Initially, 300 mg daily; increase to 600 mg daily in 2 divided doses after 3 days. Continue for 8-12 wk.
Hepatic impairment: Reduce to ½ or 1/3 of recommended dose.

Special Populations: Reduce dose by ½-1/3 in patients with severe hepatic impairment.
Contraindications
Acute confusional states and phaeochromocytoma.
Warnings / Precautions
Excited or agitated patients; bipolar disorders; hepatic impairment; thyrotoxicosis. Early antidepressant therapy; close monitoring particularly during periods of dosage adjustments. May impair ability to drive or operate machinery. Pregnancy and lactation. Withdrawal should be gradual.
Adverse Reactions
Tachycardia, hypotension, dizziness, headache, drowsiness, sleep disturbances, agitation, nervousness, sedation, somnolence, anxiety, increased appetite, xerostomia, nausea, constipation, abdominal pain, diarrhoea, vomiting, weakness, blurred vision, increased sweating, increased transaminases, elevated creatine kinase (CK) and creatine phosphokinase (CPK).
Potentially Fatal: Hypertensive crisis.
Overdose Reactions
Agitation, amnesia, convulsions, disorientation, drowsiness, hypertension, nausea, reduced reflexes, slurred speech, vomiting. Management: Symptomatic and supportive care; there is no antidote.
Drug Interactions
Increased plasma concentrations with cimetidine. Behavioural and neurologic syndromes with tryptophan. Excessive sedation and acute hypotension with CNS depressants (opiates or others analgesics, barbiturates or other sedatives, anaesthetics or alcohol). Marked hypotensive effects with diuretics and hypotensive agents. Worsening of depression and/or suicidality with antidepressants.
Potentially Fatal: Serotonin syndrome with sympathomimetic agents (e.g. amphetamines, dopamine, epinephrine, norepinephrine, methylphenidate) or related substances (e.g. methyldopa, levodopa, L-tryptophan, L-tyrosine, phenylalanine), MAOI, meperidine, TCA, serotonergic drugs (SSRI). Do not use until at least a wk after discontinuation of an SSRI or SSRI-related antidepressant, a TCA or TCA-related, or a non-selective MAOI.
See Below for More moclobemide Drug Interactions
Food Interactions
Avoid large amounts of tyramine-rich food (e.g. certain cheeses, tofu, soybeans, fish, lima beans, coffee) as the pressor effect of tyramine may be potentiated. Avoid ginkgo (may lead to MAOI toxicity). Avoid ephedra, yohimbe (can cause hypertension). Avoid kava (may increase CNS depression).
Mechanism of Actions
Moclobemide acts by reversible inhibition of the isoenzyme monoamine oxidase type A and thus preferentially increasing the availability of the neurotransmitters serotonin, epinephrine, and norepinephrine.
Absorption: Readily and 98% from the GI tract; peak plasma concentrations within 1 hr (oral).
Distribution: 50% bound to plasma proteins; enters breast milk.
Metabolism: Extensively hepatic by oxidative reactions.
Excretion: Via urine as metabolites (95%); 1-2 hr (elimination half-life).
Administration
Should be taken with food. (Take immediately after meals.)
Storage Conditions
Oral: Store at 15-30°C.
ATC Classification
N06AG02 - moclobemide ; Belongs to the class of monoamine oxidase A inhibitors. Used in the management of depression.
Storage
Oral: Store at 15-30°C.
Available As
  • Moclobemide 150 mg
  • Moclobemide 300 mg
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