Monograph Details
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Central Nervous System
> Mood disorders
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Nefazodone |
| Manufacturer |
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Various generic manufacturers |
| Legal Classification |
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Rx
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| Pharmacological Class |
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Phenylpiperazine. |
| Generic Name |
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Nefazodone HCl 50mg, 100mg+, 150mg+, 200mg, 250mg; tabs; +scored. |
| Indications |
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Depression. |
| Children |
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<18 years: not recommended. |
| Adults |
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≥18 years: initially 200mg daily in 2 divided doses; increase in increments of 100–200mg/day in 2 divided doses at 1-week intervals; range 300–600mg/day. Debilitated: initially 100mg daily in 2 divided doses. |
| Contraindications |
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Concomitant MAOIs, cisapride, carbamazepine; triazolam (see Interactions). Active liver disease. Elevated baseline serum transaminases. History of nefazodone-associated liver dysfunction. |
| Precautions |
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Monitor for liver dysfunction; discontinue if signs of liver disease occur (eg, AST or ALT ≥ 3XULN). Cardio- or cerebrovascular disease. Predisposition to hypotension (eg, dehydration, hypovolemia). Mania/hypomania. Suicidal patients. Seizure disorders. Hepatic cirrhosis. Discontinue and reevaluate if priapism occurs. ECT. Reevaluate periodically. Elderly. Debilitated. Pregnancy (Cat.C). Nursing mothers. |
| Interactions |
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Allow 14 days after discontinuing an MAOI before starting nefazodone; allow 7 days after discontinuing nefazodone before starting an MAOI. Avoid alcohol. Avoid concomitant triazolam (esp. in elderly); if used, reduce concomitant triazolam dose by 75%. Reduce concomitant alprazolam dose by 50%. Caution with antihypertensives, diuretics, other CNS-active drugs, oral anticoagulants, oral hypoglycemics, aspirin, other highly protein-bound drugs, drugs metabolized by CYP3A4. Risk of rhabdomyolysis with statins metabolized by CYP3A4 (eg, simvastatin, lovastatin, atorvastatin). May potentiate buspirone, haloperidol (reduce dose); cyclosporine, tacrolimus, digoxin (monitor). Discontinue before general anesthesia. |
| Adverse Reactions |
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Headache, nausea, dizziness, insomnia, asthenia, agitation, somnolence, dry mouth, constipation, blurred or abnormal vision, confusion, postural hypotension, priapism, others; rare: hepatic failure. |
| How Supplied |
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Contact supplier. |
| Additional Resources |
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• Related Prescribing Note |
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