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Reserpine (Reserpine) - Drug Interactions, Contraindications, Overdosage, etc



Drug Interactions

MAO inhibitors should be avoided or used with extreme caution.

Concurrent use of tricyclic antidepressants may decrease the antihypertensive effect of reserpine.

Concurrent use of reserpine and direct-or-indirect acting sympathomimetics should be closely monitored. The action of direct-acting amines (epinephrine, isoproterenol, phenylephrine, metaraminol) may be prolonged when given to patients taking reserpine. The action of indirect-acting amines (ephedrine, tyramine, amphetamines) is inhibited.

Reserpine should be used cautiously with digitalis and quinidine, since cardiac arrhythmias have occurred with rauwolfia preparations.

Concomitant use of reserpine with other antihypertensive agents necessitates careful titration of dosage with each agent.


Acute Toxicity

No deaths due to acute poisoning with reserpine have been reported.

Highest known doses survived: children, 1000 mg (age and sex not specified); young children, 200 mg (20-month-old boy).

Oral LD50's in animals (mg/kg): rat, 2993; mouse, 47 and 500.

Signs and Symptoms

The clinical picture of acute poisoning is characterized chiefly by signs and symptoms due to the reflex parasympathomimetic effect of reserpine.

Impairment of consciousness may occur and may range from drowsiness to coma, depending upon the severity of overdosage. Flushing of the skin, conjunctival injection, and pupillary constriction are to be expected. Hypotension, hypothermia, central respiratory depression, and bradycardia may develop in cases of severe overdosage. Increased salivary and gastric secretion and diarrhea may also occur.


There is no specific antidote.

Stomach contents should be evacuated, taking adequate precautions against aspiration and for protection of the airway. Activated charcoal slurry should be instilled.

The effects of reserpine overdosage should be treated symptomatically. If hypotension is severe enough to require treatment with a vasopressor, one having a direct action upon vascular smooth muscle (e.g., phenylephrine, levarterenol, metaraminol) should be used. Since reserpine is long-acting, the patient should be observed carefully for at least 72 hours, and treatment administered as required.


Known hypersensitivity, mental depression or history of mental depression (especially with suicidal tendencies), active peptic ulcer, ulcerative colitis, and patients receiving electroconvulsive therapy.

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