reserpine (Rx)

Brand and Other Names:Serpasil

Dosing & Uses

AdultPediatricGeriatric

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

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Interactions

Interaction Checker

and reserpine

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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             activity indicator 

            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)

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                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

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                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

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                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.

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                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%)

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                Images

                No images available for this drug.
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                Patient Handout

                A Patient Handout is not currently available for this monograph.
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                Formulary

                FormularyPatient Discounts

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                • Compare formulary status to other drugs in the same class.
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                The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

                Tier Description
                1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
                2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
                3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
                4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                NC NOT COVERED – Drugs that are not covered by the plan.
                Code Definition
                PA Prior Authorization
                Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
                QL Quantity Limits
                Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
                ST Step Therapy
                Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
                OR Other Restrictions
                Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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                Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.