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Oleptro™ is indicated for the treatment of major depressive disorder (MDD) in adults. The efficacy of Oleptro has been established in a trial of outpatients with MDD as well as in trials with the immediate release formulation of trazodone [see Clinical Studies].
DOSAGE AND ADMINISTRATION
The recommended starting dose of Oleptro is 150 mg once daily in adults. The dose may be increased by 75 mg/day every three days (i.e., start 225 mg on Day 4 of therapy). The maximum daily dose should not exceed 375 mg.
- Oleptro tablets should be taken orally at the same time every day, in the late evening preferably at bedtime, on an empty stomach.
- Once an adequate response has been achieved, dosage may be gradually reduced, with subsequent adjustment depending on therapeutic response.
- Patients should be monitored for withdrawal symptoms when discontinuing treatment with trazodone hydrochloride. The dose should be gradually reduced whenever possible [see WARNINGS AND PRECAUTIONS].
The efficacy of Oleptro for the maintenance treatment of MDD has not been evaluated. While there is no body of evidence available to answer the question of how long a patient treated with Oleptro should continue the drug, it is generally recommended that treatment be continued for several months after an initial response. Patients should be maintained on the lowest effective dose and be periodically reassessed to determine the continued need for maintenance treatment.
Switching A Patient To Or From A Monoamine Oxidase Inhibitor (MAOI) Intended To Treat Psychiatric Disorders
At least 14 days should elapse between discontinuation of an MAOI intended to treat psychiatric disorders and initiation of therapy with Oleptro. Conversely, at least 14 days should be allowed after stopping Oleptro before starting an MAOI intended to treat psychiatric disorders [see CONTRAINDICATIONS].
Use Of Oleptro With Other MAOIs Such As Linezolid Or Methylene Blue
Do not start Oleptro in a patient who is being treated with linezolid or intravenous methylene blue because there is an increased risk of serotonin syndrome. In a patient who requires more urgent treatment of a psychiatric condition, other interventions, including hospitalization, should be considered [see CONTRAINDICATIONS].
In some cases, a patient already receiving Oleptro therapy may require urgent treatment with linezolid or intravenous methylene blue. If acceptable alternatives to linezolid or intravenous methylene blue treatment are not available and the potential benefits of linezolid or intravenous methylene blue treatment are judged to outweigh the risks of serotonin syndrome in a particular patient, Oleptro should be stopped promptly, and linezolid or intravenous methylene blue can be administered. The patient should be monitored for symptoms of serotonin syndrome for two weeks or until 24 hours after the last dose of linezolid or intravenous methylene blue, whichever comes first. Therapy with Oleptro may be resumed 24 hours after the last dose of linezolid or intravenous methylene blue [see WARNINGS AND PRECAUTIONS].
The risk of administering methylene blue by non-intravenous routes (such as oral tablets or by local injection) or in intravenous doses much lower than 1 mg/kg with Oleptro is unclear. The clinician should, nevertheless, be aware of the possibility of emergent symptoms of serotonin syndrome with such use (see WARNINGS AND PRECAUTIONS].
Important Administration Instructions
Oleptro tablets are scored to provide flexibility in dosing.
Oleptro can be swallowed whole or administered as a half tablet by breaking the tablet along the score line. Breaking the tablet in half does not affect the controlled-release properties of the tablet.
In order to maintain its controlled-release properties, Oleptro should not be chewed or crushed.
Dosage Forms And Strengths
Oleptro tablets are available in the following strengths:
- Oleptro bisectable tablets containing 150 mg of trazodone hydrochloride (yellowish-beige, capsule-shaped tablet, coated and scored on both sides with DDS 080 printed on one side)
- Oleptro bisectable tablets containing 300 mg of trazodone hydrochloride (beige-orange, capsule-shaped tablet, coated and scored on both sides with DDS 081 printed on one side)
Storage And Handling
Oleptro 150 mg is a yellowish-beige, capsule-shaped extended-release tablet, coated and scored on both sides with DDS 080 printed on one side. It is supplied as follows:
Bottles of 30 tablets NDC 43595-080-03
Oleptro 300 mg is a beige-orange, capsule-shaped extended-release tablet, coated and scored on both sides with DDS 081 printed on one side. It is supplied as follows:
Bottles of 30 tablets NDC 43595-081-03
Store at room temperature (15 – 30°C) in tight, light-resistant containers.
Angelini Pharma Inc. Gaithersburg, MD 20877. Revised: July 2014
Last reviewed on RxList: 8/1/2014
This monograph has been modified to include the generic and brand name in many instances.
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