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Nefazodone (Nefazodone Hydrochloride) - Summary

 


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BOXED WARNING

Warning

Cases of life-threatening hepatic failure have been reported in patients treated with nefazodone hydrochloride tablets. The reported rate in the United States is about 1 case of liver failure resulting in death or transplant per 250,000 to 300,000 patient-years of nefazodone hydrochloride treatment. The total patient-years is a summation of each patient’s duration of exposure expressed in years. For example, 1 patient-year is equal to 2 patients each treated for 6 months, 3 patients each treated for 4 months, etc. (See WARNINGS.)

Ordinarily, treatment with nefazodone hydrochloride tablets should not be initiated in individuals with active liver disease or with elevated baseline serum transaminases. There is no evidence that pre-existing liver disease increases the likelihood of developing liver failure, however, baseline abnormalities can complicate patient monitoring.

Patients should be advised to be alert for signs and symptoms of liver dysfunction (jaundice, anorexia, gastrointestinal complaints, malaise, etc.) and to report them to their doctor immediately if they occur.

Nefazodone hydrochloride tablets should be discontinued if clinical signs or symptoms suggest liver failure (see PRECAUTIONS, Information for Patients). Patients who develop evidence of hepatocellular injury such as increased serum AST or serum ALT levels ≥ 3 times the upper limit of NORMAL , while on nefazodone hydrochloride tablets should be withdrawn from the drug. These patients should be presumed to be at increased risk for liver injury if nefazodone hydrochloride is reintroduced. Accordingly, such patients should not be considered for re-treatment.

 

NEFAZODONE SUMMARY

NEFAZODONE HYDROCHLORIDE TABLETS

(Patient Information Included)

Nefazodone hydrochloride tablets are an antidepressant for oral administration with a chemical structure unrelated to selective serotonin reuptake inhibitors, tricyclics, tetracyclics, or monoamine oxidase inhibitors (MAOI). Nefazodone hydrochloride is a synthetically derived phenylpiperazine antidepressant.

Nefazodone hydrochloride tablets are indicated for the treatment of depression. When deciding among the alternative treatments available for this condition, the prescriber should consider the risk of hepatic failure associated with nefazodone hydrochloride treatment (see WARNINGS). In many cases, this would lead to the conclusion that other drugs should be tried first.

The efficacy of nefazodone in the treatment of depression was established in 6 to 8 week controlled trials of outpatients and in a 6 week controlled trial of depressed inpatients whose diagnoses corresponded most closely to the DSM-III or DSM-IIIR category of major depressive disorder (see CLINICAL PHARMACOLOGY).

A major depressive episode implies a prominent and relatively persistent depressed or dysphoric mood that usually interferes with daily functioning (nearly every day for at least 2 weeks). It must include either depressed mood or loss of interest or pleasure and at least five of the following nine symptoms: depressed mood, loss of interest in usual activities, significant change in weight and/or appetite, insomnia or hypersomnia, psychomotor agitation or retardation, increased fatigue, feelings of guilt or worthlessness, slowed thinking or impaired concentration, a suicide attempt or suicidal ideation.

The efficacy of nefazodone in reducing relapse in patients with major depression who were judged to have had a satisfactory clinical response to 16 weeks of open-label nefazodone treatment for an acute depressive episode has been demonstrated in a randomized placebo-controlled trial (see CLINICAL PHARMACOLOGY). Although remitted patients were followed for as long as 36 weeks in the study cited (i.e., 52 weeks total), the physician who elects to use nefazodone for extended periods should periodically reevaluate the long-term usefulness of the drug for the individual patient.


See all Nefazodone indications & dosage >>

NEFAZODONE NEWS HIGHLIGHTS

Media Articles Related to Nefazodone

Depression linked to poorer diabetes control (Reuters)
Source: Y! Health Depression News [2008.11.19]

Depression Screening May Not Benefit Heart Disease Patients
Source: Depression News From Medical News Today [2008.11.17]

AMPAKINE(R) Compounds May Protect From Drug-induced Respiratory Depression While Still Allowing The Sedative Or Analgesic To Continue Working
Source: Respiratory / Asthma News From Medical News Today [2008.11.16]

Greater Risk Of Death For African-Americans With Depression And Heart Attack
Source: Depression News From Medical News Today [2008.11.13]

Heart Association Call For Routine Screening Of Heart Patients For Depression Is Premature, Johns Hopkins Expert Says
Source: Depression News From Medical News Today [2008.11.12]

more >>

Published Studies Related to Nefazodone

Nefazodone in the treatment of generalized social phobia: a randomized, placebo-controlled trial. [2007.02]

Chronic depression: medication (nefazodone) or psychotherapy (CBASP) is effective when the other is not. [2005.05]

Nefazodone in out-patient treatment of inhaled cocaine dependence: a randomized double-blind placebo-controlled trial. [2005.04]

Efficacy screening trials of paroxetine, pentoxifylline, riluzole, pramipexole and venlafaxine in cocaine dependence. [2005.03]

Combination treatment with nefazodone and cognitive-behavioral therapy for relapse prevention in alcohol-dependent men: a randomized controlled study. [2004.10]

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Clinical Trials Related to Nefazodone

Nefazodone in the Treatment of Cocaine Dependence and Depression - 4 [Active, not recruiting]

Nefazodone in the Treatment of Social Phobia [Completed]

Effect of Nefazodone on Relapse in Females With Cocaine Abuse - 10 [Completed]

Effectiveness of Nefazodone and Bupropion in Treating Marijuana Dependent Individuals [Completed]

Effects of Nefazodone on Treatment of Female Cocaine Abusers - 3 [Completed]

more >>

Page last updated: 2008-11-19

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