Introduction
Neocipran 50 is a prescription medicine used in the treatment of fibromyalgia (a condition in which there are generalized pain and tenderness in the body) and depression. It works by increasing the level of chemical messengers (serotonin and noradrenaline), helping in faster recovery.
Neocipran 50 may be taken with or without food. It is advised to take this medicine at a fixed time each day to maintain a consistent level in the blood. If you miss any doses, take it as soon as you remember. Do not skip any doses and finish the full course of treatment even if you feel better. It is important that this medication is not stopped suddenly as it may worsen your symptoms.
Some common side effects of this medicine include nausea, vomiting, insomnia (difficulty sleeping), constipation, anxiety, decreased appetite, increased sweating, and sexual dysfunction. It even causes dizziness and sleepiness, so do not drive or do anything that requires mental focus until you know how this medicine affects you. However, these side effects are temporary and usually resolve on their own in some time. Please consult your doctor if these do not subside or bother you.
Before taking Neocipran 50, inform your doctor if you have any problems with your kidneys, heart, liver, or have a history of seizures (epilepsy or fits). Inform your doctor if you develop any unusual changes in mood or behavior, new or worsening depression, or if you have any suicidal thoughts.
Side effects of Neocipran 50
Common
- Nausea
- Vomiting
- Dizziness
- Insomnia (difficulty in sleeping)
- Constipation
- Anxiety
- Decreased appetite
- Increased sweating
- Sexual dysfunction
How to use Neocipran 50
Take this medicine in the dose and duration as advised by your doctor. Do not chew, crush or break it. Neocipran 50 may be taken with or without food, but it is better to take it at a fixed time.
How Neocipran 50 works
Neocipran 50 works by increasing the levels of chemical messengers (serotonin and noradrenaline), natural substances in the brain that help maintain mental balance and stop the movement of pain signals in the brain.
What if you forget to take Neocipran 50?
If you miss a dose of Neocipran 50, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.
Indication
Depression, Fibromyalgia
Administration
Should be taken with food. Preferably taken during meals.
Adult Dose
Oral
Fibromyalgia
Adult:
Day 1: 12.5 mg once
Days 2-3: 25 mg/day (12.5 mg twice daily)
Days 4-7: 50 mg/day (25 mg twice daily)
After Day 7: 100 mg/day (50 mg twice daily)
Based on individual patient response, the dose may be increased to 200 mg/day (100 mg twice daily).
Depression
Adult: 50 mg bid.
Hepatic impairment
Mild or moderate (Child-Pugh A or B): No dosage adjustment required
Severe (Child-Pugh C): Caution advised
Child Dose
<17 years: Safety and efficacy not established
Renal Dose
Renal impairment
Mild (CrCl 50-80 mL/min): No dosage adjustment required
Moderate (CrCl 30-49 mL/min): Use with caution
Severe (CrCl 5-29 mL/min): Reduce maintenance dosage by 50% (ie, to 50 mg/day divided q12hr)
End-stage renal disease (ESRD): Use not recommended
Contraindication
Uncontrolled narrow-angle glaucoma. Concomitant use w/ MAOI or w/in 2 wk after withdrawal of MAOI.
Mode of Action
SNRI; has no affinity for other neurotransmitter receptors (including gamma-aminobutyric acid [GABA], beta-adrenergic, opiate, histaminergic, and benzodiazepine receptors) and has no MAOI activity.
Precaution
Patient w/ major depressive disorder or other psychiatric disorders, history of dysuria, controlled narrow-angle glaucoma, pre-existing HTN, tachyarrhythmias or other CV disease, history of seizure disorder or condition predisposing to seizures (e.g. brain damage, alcoholism). Avoid abrupt withdrawal. Severe hepatic and moderate to severe renal impairment including ESRD. Pregnancy and lactation.
Lactation: Drug is excreted in human milk; peak breast milk concentration is observed within 4 hours after maternal dose, and estimated infant exposure is 5% of maternal dose; limited data are available regarding infant exposure, but caution is advised
Side Effect
>10%
Nausea (37%),Headache (18%),Constipation (16%),Hot flush (12%),Insomnia (12%)
1-10% (selected)
Dizziness,Hyperhidrosis,Hypertension,Migraine,Palpitations,Tachycardia,Vomiting,Xerostomia
Frequency Not Defined
Abnormal bleeding,Depression (worsening),Serotonin syndrome,Suicidal thoughts,Withdrawal signs or symptoms
Potentially Fatal: Serotonin syndrome or neuroleptic malignant syndrome (NMS)-like reactions, suicidal thinking/behaviour.
Interaction
Increased risk of bleeding w/ aspirin, NSAIDs, warfarin and other drugs that affect coagulation. Increased CNS effects w/ centrally-acting drugs (e.g. clomipramine). Increased risk of serotonin syndrome and NMS-like reactions w/ serotonergic drugs (e.g. tramadol), SSRIs, other selective serotonin-norepinephrine reuptake inhibitors, 5-HT1 receptor agonists (e.g. sumatriptan), antipsychotic agents and other dopamine antagonists. May inhibit antihypertensive effect of clonidine. May potentiate adverse haemodynamic effects w/ digoxin. Paroxysmal HTN and cardiac arrhythmia may occur when taken concurrently w/ epinephrine or norepinephrine.
Potentially Fatal: Increased risk of serotonin syndrome and NMS-like reactions w/ MAOIs (e.g. linezolid, IV methylene blue).