Reserpine

Registered South African indications:

• Hypertension

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients
• Pregnancy
• Lactation
• History of mental depression
• Active peptic ulcer
• Ulcerative colitis
• Gallstones
• Phaeochromocytoma
• Parkinson's disease
• Epilepsy
• Electroconvulsive therapy

Cautions

• Severe renal impairment
• Elderly
• Allergic conditions
• Cardiac arrhythmias
• Myocardial infarction
• Severe cardiac damage
• Gallstones

Forms avail. in SA and covered in this monograph: tab

Hypertension- mild to moderate

• Oral (tab): 0.25mg, dly for 2 weeks then reduce to lowest dose needed to maintain response; Max: 0.25mg/24hrs

Take with meals or milk to reduce gastric irritation

Usually used in combination with diuretic to reduce the required dose

Not established for use in children below 18 years

Pregnancy

• Contraindicated

Breastfeeding

• Contraindicated

Renal Impairment

• Mild to moderate: No dose adjustment recommended
• Severe: Caution; no dose adjustment recommended
  Use is not recommended

Hepatic Impairment

• No dose adjustment recommended

Elderly

• Caution; dose adjustment recommended
  Initial: 0.05mg daily; Titrate by 0.05mg at intervals of 1 week, as needed; Avoid doses > 0.1mg/day (Beers Criteria)

Porphyria Information

• Not yet classified (NC)

Drugs in Sport

•  Permitted - No warnings

Central Nervous System Disorders

• Dizziness
• Depression
• Suicide
• Extrapyramidal effects
• Drowsiness
• Inability to concentrate
• Lethargy
• Nightmares

Cardiovascular Disorders

• Flushing
• Bradycardia

Respiratory Disorders

• Respiratory distress (infants with maternal exposure)
• Cyanosis (infants with maternal exposure)

Gastrointestinal Disorders

• Increased gastrointestinal tract motility
• Increased gastric acid secretion
• Dry mouth
• Sialorrhoea

Hepatobiliary Disorders

• Biliary colic (patients with pre-existing gallstones)

Genitourinary Disorders

• Impotence

Endocrine and Metabolic Disorders

• Galactorrhoea
• Breast engorgement
• Increased prolactin
• Decreased libido
• Increased appetite
• Weight gain
• Anorexia (infants with maternal exposure)
• Hypothermia (infants with maternal exposure)

Immune, Blood and Lymphatic System Disorders

• Oedema
• Thrombocytopenic purpura

Sensory Disorders

• Miosis

• Sympathomimetics
• Central nervous system depressants
• Thiazide diuretics
• Antihypertensives
• Monoamine oxidase inhibitors
• Digitalis
• Quinidine
• Non-steroidal anti-inflammatory drugs

None routine

Reserpine acts by depleting biogenic amines at central and peripheral adrenergic neurons. The resulting sympathetic nervous system dysfunction causes a reduction in cardiac output and peripheral vascular resistance which leads to a reduction in blood pressure. In order to regenerate the amines, new storage vesicles need to be synthesised in the adrenergic neurons which can take days to weeks. Therefore, reserpine effects can persist for up to 6 weeks after treatment discontinued.

Tablet 0.25mg

• A-Lennon Reserpine (Pharmacare)