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(nefazodone hydrochloride) Tablets
Cases of life-threatening hepatic failure have been reported in patients treated with SERZONE (nefazodone) . The reported rate in the United States is about 1 case of liver failure resulting in death or transplant per 250,000- 300,000 patient-years of SERZONE (nefazodone) treatment. The total patient-years is a summation of each patients 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 SERZONE (nefazodone) 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.
SERZONE (nefazodone) 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as increased serum AST or serum ALT levels ≥ 3 times the upper limit of NORMAL, while on SERZONE (nefazodone) should be withdrawn from the drug. These patients should be presumed to be at increased risk for liver injury if SERZONE (nefazodone) is reintroduced. Accordingly, such patients should not be considered for re-treatment.
Antidepressants increased the risk of suicidal thinking and behavior (suicidality) in short-term studies in children and adolescents with Major Depressive Disorder (MDD) and other psychiatric disorders. Anyone considering the use of SERZONE (nefazodone) or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Patients who are started on therapy should be observed closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. SERZONE (nefazodone) is not approved for use in pediatric patients. (See WARNINGS and PRECAUTIONS: Pediatric Use.)
Pooled analyses of short-term (4 to 16 weeks) placebo-controlled trials of nine antidepressant drugs (SSRIs and others) in children and adolescents with major depressive disorder (MDD), obsessive compulsive disorder (OCD), or other psychiatric disorders (a total of 24 trials involving over 4400 patients) have revealed a greater risk of adverse events representing suicidal thinking or behavior (suicidality) during the first few months of treatment in those receiving antidepressants. The average risk of such events in patients receiving antidepressants was 4%, twice the placebo risk of 2%. No suicides occurred in these trials.
SERZONE® (nefazodone hydrochloride) is 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. The chemical name for nefazodone hydrochloride is 2-[3-[4-(3-chlorophenyl) -1-piperazinyl]propyl] -5-ethyl-2,4-dihydro-4-(2-phenoxyethyl) -3H-1,2,4-triazol-3-one monohydrochloride. The molecular formula is C25H32ClN5O2 HCl, which corresponds to a molecular weight of 506.5. The structural formula is:
Nefazodone hydrochloride is a nonhygroscopic, white crystalline solid. It is freely soluble in chloroform, soluble in propylene glycol, and slightly soluble in polyethylene glycol and water.
SERZONE (nefazodone) is supplied as hexagonal tablets containing 50 mg, 100 mg, 150 mg, 200 mg, or 250 mg of nefazodone hydrochloride and the following inactive ingredients: microcrystalline cellulose, povidone, sodium starch glycolate, colloidal silicon dioxide, magnesium stearate, and iron oxides (red and/or yellow) as colorants.
What are the precautions when taking nefazodone (Serzone)?
See also Warning section.
Before taking nefazodone, tell your doctor or pharmacist if you are allergic to it; or to trazodone; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, personal or family history of psychiatric disorder (e.g., bipolar/manic-depressive disorder), personal or family history of suicide attempts, heart/blood vessel disease (e.g., history of stroke/heart attack), loss of too much body water (dehydration), seizures, intestinal ulcers/bleeding (peptic ulcer disease).
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Last reviewed on RxList: 5/1/2008
This monograph has been modified to include the generic and brand name in many instances.
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