reserpine (Rx)

Brand and Other Names:Serpasil
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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 (0)

                Monitor Closely (3)

                • 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.

                • esketamine intranasal

                  esketamine intranasal, reserpine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.

                • 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

                  Adding plans allows you to compare formulary status to other drugs in the same class.

                  To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

                  Adding plans allows you to:

                  • View the formulary and any restrictions for each plan.
                  • Manage and view all your plans together – even plans in different states.
                  • Compare formulary status to other drugs in the same class.
                  • Access your plan list on any device – mobile or desktop.

                  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.