Reboxetine

Indications
 Oral
Depression
Adult: 4 mg bid, may increase to 10 mg daily after 3-4 wk if necessary. Max: 12 mg daily.
Elderly: 2 mg bid, may increase dose to 6 mg/day after 3 ww if required.
Renal impairment: Initiate with lower doses: 2 mg bid; may increase gradually according to tolerance.
Hepatic impairment: Initiate with lower doses: 2 mg bid; may increase gradually according to tolerance.

Special Populations: Reduce initial dose to 4 mg daily in patients with hepatic or renal impairment.
Warnings / Precautions
 Renal and hepatic impairment, benign prostatic hyperplasia, cardiac disorders, epilepsy, bipolar disorders, urinary retention, glaucoma. May impair ability to perform tasks requiring mental alertness, driving or operating machinery. Monitor for signs of clinical worsening eg. suicidal tendency especially during the initial phase of the treatment.
Adverse Reactions
 Insomnia, dizziness, increased sweating, impotence, dry mouth, constipation, urinary hesitancy, dry mouth, postural hypotension, dysuria, paraesthesia, hyponatraemia, tachycardia.
Potentially Fatal: Tachycardia.
Drug Interactions
 Avoid concomitant admin with antiarrhythmics, antipsychotics, ciclosporin, imidazole and triazole antifungals, TCAs. Concurrent use with CYP3A4 inhibitors may increase plasma levels of reboxetine. Concurrent use with ergot derivatives may increase BP.
Potentially Fatal: Risk of hypertensive crisis when used with MAOIs.
See Below for More reboxetine Drug Interactions
Mechanism of Actions
 Reboxetine selectively and potently inhibits norepinephrine reuptake. It also has a weak effect on serotonin reuptake.
Absorption: Well absorbed; peak plasma concentrations about 2 hr after oral dose.
Distribution: Protein-binding: 97%.
Metabolism: Metabolised by CYP3A4. Dealkylation, hydroxylation, oxidation followed by glucuronide and sulfate conjugations.
Excretion: Mainly via urine (78%) with 10% as unchanged drug; 13 hr (elimination half-life).
Administration
 May be taken with or without food.
ATC Classification
 N06AX18 - reboxetine ; Belongs to the class of other antidepressants.
Available As
  • Reboxetine 2 mg
  • Reboxetine 4 mg

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