Amoxapine(a mox’ a peen)
PREGNANCY CATEGORY C
Drug Classes
Anxiolytic
TCA
Therapeutic Actions
Mechanism of action unknown; TCAs inhibit the reuptake of the neurotransmitters norepinephrine and serotonin, leading to an increase in their effects; anticholinergic at CNS and peripheral receptors; sedative.
Indications
Relief of symptoms of depression in patients with neurotic or reactive depressive disorders and in those with endogenous and psychotic depression (endogenous depression most responsive)
Treatment of depression accompanied with anxiety or agitation
Contraindications and Cautions
Contraindicated with hypersensitivity to tricyclic drugs; concomitant use with an MAOI; recent MI; myelography within previous 24 hr or scheduled within 48 hr; lactation.
Use cautiously with EST; preexisting CV disorders (severe coronary heart disease, progressive heart failure, angina pectoris, paroxysmal tachycardia); angle-closure glaucoma, increased IOP, urinary retention, ureteral or urethral spasm; seizure disorders; hyperthyroidism; psychiatric patients (schizophrenic or paranoid patients may exhibit a worsening of psychosis); patients with bipolar disorder; elective surgery (discontinue as soon as possible before surgery), pregnancy.
Available Forms
Tablets—25, 50, 100, 150 mg
Dosages
Adults
Initially, 50 mg PO bid–tid; gradually increase to 100 mg bid–tid by end of first wk if tolerated; increase above 300 mg/day only if this dosage ineffective for at least 2 wk. Hospitalized patients refractory to antidepressant therapy and with no history of seizures may be given up to 600 mg/day in divided doses; after effective dosage is established, drug may be given in a single dose at bedtime (maximum, 300 mg). Usual effective dose is 200–300 mg/day.
Pediatric patients
Not recommended for patients younger than 16 yr.
Geriatric patients
Initially, 25 mg bid–tid; if tolerated, dosage may be increased by end of first week to 50 mg bid–tid. For many elderly patients, 100–150 mg/day may be adequate; some may require up to 300 mg/day. Once effective dose is established, give as single dose at bedtime, not to exceed 300 mg.
Pharmacokinetics
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