Composition
Tab 25 mg/75 mg: Dothiepin 25 mg/75 mg.
Indications & Dosage
Depressive illness, particularly where sedation is required: Adult: Initially 75 mg daily in divided doses, alternatively initially 75 mg once daily, dose to be taken at bedtime, increased if necessary to 150 mg daily, doses to be increased gradually; up to 225 mg daily in some circumstances, reduced dose in elderly.
Contraindications
Acute porphyrias, arrhythmias, during the manic phase of bipolar disorder, heart block, recent myocardial infarction, severe hepatic impairment.
Precautions
Cardiovascular disease, diabetes, epilepsy, glaucoma, chronic constipation, history of bipolar disorder, history of psychosis, hyperthyroidism (risk of arrhythmias),increased intra-ocular pressure, patients with risk of suicide phaeochromocytoma (risk of arrhythmias), prostatic hypertrophy, susceptibility to angle-closure glaucoma, urinary retention, prostatic hypertrophy, cardiovascular disorders, suicidal tendencies, elderly. Withdraw gradually.
Interactions
With or within 14 days of MAOls, other antide-pressants, CNS depressants, antihypertensives, sympathomimetics, drugs affecting cardiac conduction (e.g. Sotalol), barbiturates.
Pregnancy
Avoid unless potential benefit outweighs risk
Lactation
Contraindicated, avoid
Side Effects
Agitation, anorexia, fatigue, hypertension, mydriasis, oedema, palpitation, restlessness, stomatitis, blurred vision, confusion, constipation, convulsions, delusions, dizziness, drowsiness, dry mouth, ECG changes, gynaecomastia, haematological reactions, hallucinations, headache, heart block, hepatic reactions, hypomania, hyponatraemia, increased intra-ocular pressure, irritability, mania, movement disorders, myalgia, paraesthesia, photosensitivity, postural hypotension, pruritus, rash, sexual dysfunction, sleep disturbances, suicidal behavior, sweating, tachycardia, tinnitus, urinary retention, urticaria, vomiting, weight changes. Rare: Alopecia, arrhythmia, dysarthria, extrapyramidal symptoms, paralytic ileus, tremor