Nefazodone

Nefazodone is an antidepressant that is used to treat depression, including major depressive disorder.

Nefazodone is not chemically similar to other types of antidepressants, such as selective serotonin reuptake inhibitors or "SSRIs", tricyclic antidepressants, or monoamine oxidase inhibitors or "MAOIs."

Nefazodone may also be used for other reasons that are not included in this medication guide.

Follow all instructions on your prescription label and read all medication guides or instruction sheets. Your doctor may change your dose from time to time. Use the medicine exactly as directed.

Take the medicine at the same time each day, whether you eat or not.

You may need regular blood tests to check how your liver is working.

Your symptoms may take several weeks to improve.

Inform your doctor if you have a surgery scheduled.

Keep the medicine at room temperature, away from moisture and heat.

Some young people may have thoughts about suicide when they first start taking an antidepressant. Pay attention to any changes in your mood or symptoms. Let your doctor know about any new or worsening symptoms.

Inform your doctor about all the other medicines you are taking. Certain drugs should not be used with nefazodone.

You should not take nefazodone if you are allergic to nefazodone or trazodone, or if you have ever had liver problems caused by taking nefazodone.

Some drugs should not be used with nefazodone. Your treatment plan may change if you also use:

• carbamazepine;
• cisapride;
• pimozide; or
• an MAO inhibitor such as isocarboxazid, linezolid, methylene blue injection, phenelzine, or tranylcypromine.

You must wait at least 14 days after stopping an MAO inhibitor before you can take nefazodone. You must wait 7 days after stopping nefazodone before you can take an MAOI.

Tell your doctor if you have ever had:

• bipolar disorder (manic depression);
• epilepsy or other seizure disorder;
• suicidal thoughts or actions;
• heart disease or recent heart attack;
• liver disease (especially cirrhosis); or
• narrow-angle glaucoma.

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Tell your doctor if you are pregnant or breastfeeding.

Not approved for use by anyone younger than 18 years old.

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: changes in mood or behavior, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Nefazodone may cause serious side effects. Call your doctor right away if you have:

• problems with vision;
• a seizure;
• feeling light-headed, like you might pass out;
• manic episodes—racing thoughts, increased energy, decreased need for sleep, risk-taking behavior, being agitated or talkative; or
• liver problems—loss of appetite, stomach pain (upper right side), tiredness, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Common side effects of nefazodone may include:

• drowsiness, dizziness, weakness;
• vision problems;
• nausea, constipation;
• confusion, agitation; or
• dry mouth.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Usual Adult Dose for Depression:

Initial dose: 200 mg orally per day in two divided dosesMaintenance dose: 300 to 600 mg orally per dayComments:-Dose increases should occur in increments of 100 mg per day to 200 mg per day, on a 2 times a day schedule, and at intervals of no less than 1 week.-Several weeks may be required for full effect.-Patients in long-term studies were followed for up to 52 weeks; patients receiving prolonged treatment should be periodically assessed for usefulness.Use: Treatment of depression, including major depressive disorder

Usual Geriatric Dose for Depression:

Elderly or debilitated patients:-Initial dose: 100 mg orally per day administered in two divided doses-Maintenance dose: Up to 300 to 600 mg orally per dayComments:-Since these patients often have reduced drug clearance and/or increased sensitivity to the side effects, it may be appropriate to modify the rate of subsequent dose titration.-Several weeks may be required for full effect.-Patients in long-term studies were followed for up to 52 weeks; patients receiving prolonged treatment should be periodically assessed for usefulness.Use: Treatment of depression, including major depressive disorder

Skip the missed dose and take your next dose at the usual time. Do not take two doses at the same time.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

• Avoid drinking alcohol.

• Avoid driving or hazardous activity until you know how nefazodone will affect you. Your reactions could be impaired.

• Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.

Using nefazodone with other drugs that make you drowsy can make you feel even more sleepy. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures.

Tell your doctor about all your other medicines, especially:

• buspirone;
• digoxin;
• fluoxetine, Prozac, Symbyax;
• propranolol;
• cholesterol medication--atorvastatin, lovastatin, simvastatin;
• immunosuppressive medicine--cyclosporine, tacrolimus; or
• a sedative like Valium--alprazolam, estazolam, midazolam, triazolam, Xanax, Versed, Halcion.

This list is not complete and many other drugs may affect nefazodone. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.