Therapeutic Class |
Central Monoamine-Depleting Agent; Rauwolfia Alkaloid |
Indications |
Management of mild-to-moderate hypertension; treatment of agitated psychotic states (schizophrenia), Management of tardive dyskinesia. |
Adult Doses |
Usual dose range: 0.05-0.25 mg once daily; 0.1 mg every other day may be given to achieve 0.05 mg once daily Hypertension: Initial: 0.1 mg once daily; adjust as necessary based on response. Schizophrenia or tardive dyskinesia Dosing recommendations vary; initial dose recommendations generally range from 0.05-0.25 mg. May be increased in increments of 0.1-0.25 mg; maximum dose in tardive dyskinesia: 5 mg/day Elderly: Oral: Initial: 0.05 mg once daily increasing by 0.05 mg every week as necessary; full antihypertensive effects may take as long as 3 weeks |
Pediatric Doses |
Hypertension: |
Doses in Renal impairment |
Not removed by hemo- or peritoneal dialysis; supplemental dose is not necessary Clcr <10 mL/minute: Avoid use. |
Contraindications |
Active peptic ulcer or ulcerative colitis; depression; Parkinson's disease; pheochromocytoma; electroconvulsive therapy (ECT). |
Warnings / Precautions |
Elderly or debilitated patients; epilepsy; renal insufficiency; gallstones; allergic conditions; cardiac arrhythmias; MI. Maintain an interval of at least 7-14 days between the last dose of reserpine and start of ECT. |
Adverse Reactions |
Nasal congestion; headache; CNS disorders; GI disturbances; breast engorgement, galactorrhoea; gynaecomastia, decreased libido, impotence, Na retention, oedema, decreased or increased appetite; weight gain, miosis, dry mouth, sialorrhoea, dysuria, rashes, pruritus, thrombocytopaenic purpura. |
Overdose Reactions |
Signs include CNS depression ranging from drowsiness to coma. |
Drug Interactions |
Hypotensive effects enhanced by thiazide diuretics and other antihypertensives. May cause excitation and hypertension with MAOIs. May cause cardiac arrhythmias with digitalis or quinidine. Effects of CNS depressants may be enhanced. May decrease patient's response to levodopa. |
Lab Interactions |
May cause a slight increase in urinary 5-hydroxyindoleacetic acid excretion. May also interfere with colorimetric assay procedures for the determination of urinary 17-hydroxycorticosteroids by the Glenn-Nelson technique and 17-ketosteroids by the Holtorff Koch modification of the Zimmerman reaction. |
Food Interactions |
Ethanol: May increase CNS depression; monitor for increased effects with coadministration. Caution patients about effects. Herb/Nutraceutical: Avoid dong quai if using for hypertension (has estrogenic activity). Avoid ephedra, yohimbe (may worsen hypertension). Avoid valerian, St John's wort, kava kava, gotu kola (may increase CNS depression). Avoid garlic (may have increased antihypertensive effect). |
Mechanism of Actions |
Reduces blood pressure via depletion of sympathetic biogenic amines (norepinephrine and dopamine); this also commonly results in sedative effects |
Metabolism |
Inhibits P-glycoprotein |
Pharmacodynamics |
Onset of action: Antihypertensive: 3-6 days Duration: 2-6 weeks Absorption: ~40% Distribution: Crosses placenta; enters breast milk Protein binding: 96% Metabolism: Extensively hepatic (>90%) Half-life elimination: 50-100 hours Excretion: Feces (30% to 60%); urine (10%) |
Monitoring |
Blood pressure, standing and sitting/supine |
Administration |
Should be taken with food. |
Pregnancy Category |
C: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks. |
Lactation |
Enters breast milk/use caution |
Storage Conditions |
Oral: Store at 20-25°C. |
ATC Classification |
C02AA02 - reserpine ; Belongs to the class of rauwolfia alkaloids, centrally-acting antiadrenergic agents. Used in the treatment of hypertension. |
GenericPedia Classification |
|
Storage |
Oral: Store at 20-25°C. |
Available As |
|
Reserpine
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Reserpine Containing Brands
Reserpine is used in following diseases
Drug - Drug Interactions of Reserpine
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