Dosing & Uses
Dosage Forms & Strengths
tablet
- 0.1mg
- 0.25mg
Hypertension
Initial
- 0.5 mg daily for 1 or 2 weeks
Maintenance
- 0.1-0.25 mg PO qDay
- Use higher dosages cautiously occurrence of mental depression or other adverse reactions may increase
Psychiatric Disorders
0.5 mg daily, but may range from 0.1 to 1 mg; titrate dose according to patient response
Tardive Dyskinesia
0.25 mg q6hr; may increase by 0.1-0.25 mg to a total of 5 mg daily
Dosage Forms & Strengths
tablet
- 0.1mg
- 0.25mg
Hypertension
0.02 mg/kg/day PO qDay or divided q12hr, not to exceed 0.25 mg/day
Adverse CNS effects; may cause bradycardia and orthostatic hypotension; not recommended as routine treatment for hypertension (Beers criteria)
0.05 mg PO qDay; may increase by 0.05 mg after 1 week as needed; not to exceed 0.1 mg/day
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (1)
- deutetrabenazine
reserpine increases toxicity of deutetrabenazine by pharmacodynamic synergism. Contraindicated. Reserpine binds irreversibly to VMAT2 and the duration of its effect is several days. Wait for chorea to reemerge before administering deutetrabenazine to help reduce the risk of overdosage and major depletion of serotonin and norepinephrine in the CNS. At least 20 days should elapse after stopping reserpine before starting deutetrabenazine. Do not use these drugs concomitantly.
Monitor Closely (16)
- acrivastine
acrivastine and reserpine both increase sedation. Use Caution/Monitor.
- amisulpride
amisulpride and reserpine both increase sedation. Use Caution/Monitor.
- asenapine
asenapine and reserpine both increase sedation. Use Caution/Monitor.
- asenapine transdermal
asenapine transdermal and reserpine both increase sedation. Use Caution/Monitor.
- avapritinib
avapritinib and reserpine both increase sedation. Use Caution/Monitor.
- benzhydrocodone/acetaminophen
benzhydrocodone/acetaminophen and reserpine both increase sedation. Use Caution/Monitor.
- berotralstat
reserpine increases levels of berotralstat by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Reduced berotralstat dose to 110 mg/day when coadministered with P-gp inhibitors.
- brexpiprazole
brexpiprazole and reserpine both increase sedation. Use Caution/Monitor.
- brimonidine
brimonidine and reserpine both increase sedation. Use Caution/Monitor.
- brivaracetam
brivaracetam and reserpine both increase sedation. Use Caution/Monitor.
- buprenorphine subdermal implant
buprenorphine subdermal implant and reserpine both increase sedation. Use Caution/Monitor.
- buprenorphine transdermal
buprenorphine transdermal and reserpine both increase sedation. Use Caution/Monitor.
- buprenorphine, long-acting injection
buprenorphine, long-acting injection and reserpine both increase sedation. Use Caution/Monitor.
- esketamine intranasal
esketamine intranasal, reserpine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.
- ganaxolone
reserpine and ganaxolone both increase sedation. Use Caution/Monitor.
- lemborexant
lemborexant, reserpine. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects.
Minor (0)
Adverse Effects
Frequency Not Defined
Angina
Bradycardia
Anorexia
Peripheral edema
Syncope
Premature ventricular contractions
Dizziness
Depression
Lethargy
Pruritus
Weight gain
Thrombocytopenia purpura
Gynecomastia
Rash
Nightmare
Nervousness
Paradoxical anxiety
Tardive dyskinesia
GI hypersecretion
Impotence
Blurred vision
Optic atrophy
Decreased libido
Nasal congestion
Warnings
Contraindications
Hypersensitivity, active peptic ulcer, ulcerative colitis, history of depression, history of gallstones; electroconvulsive treatment within 1 week
Cautions
Use caution in asthma, gallstones, Parkinson's disease, renal impairment, inflammatory bowel disease or history of peptic ulcer disease
Significant mental depression may occur with high doses
Use caution in patients at risk of hypotension
History of gall stones, PUD, ulcerative colitis
Breastfeeding
Avoid during breast-feeding
Pregnancy & Lactation
Pregnancy Category: C
Lactation: unsafe; excreted into breast milk
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Peripheral adrenergic neuron antagonist via depletion of tissue store of catecholamines (norepinephrine, dopamine) resulting in lower blood pressure and sedative effects.
Absorption
Bioavailability: 30-40%
Duration: 2-6 weeks
Distribution
Protein binding: 96%
Metabolism
Extensively metabolized in the liver
Metabolites: trimethylbenzoic acid, methyl reserpate (inactive)
Elimination
Half-Life: 50-100 hr
Excretion: Feces (30-60%); urine (12%)
Images
Formulary
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