Melitracen is a tricyclic antidepressant respectively, for the treatment of depression and anxiety. In addition to single drug preparations, it is also available as Deanxit, a combination product containing both melitracen and flupentixol
Mechanism of action of Melitracen
Flupentixol inhibits dopamine-mediated effects by blocking postsynaptic dopamine receptors in the CNS. Melitracen is a TCA with anxiolytic properties. At low doses, it has to activate properties. It is also a bipolar thymoleptic.
Absorption: Flupentixol: Readily absorbed in the GI tract.
Distribution: Flupentixol: >95% bound to plasma proteins; widely distributed in the body and crosses the blood-brain barrier.
Metabolism: Flupentixol: Extensively hepatic metabolism.
Excretion: Flupentixol: Excreted in urine and feces in the form of many metabolites.
Indications of Melitracen
- Depressive illness
- Anxiety or bipolar illness. Its second component, melitracen acts against bipolar illnesses.
- Psychogenic depression
- Menopausal depression, where nothing else works
- Long lasting myogenic headache
- Resistant migraines
- Certain gastrointestinal disturbances which have a neurological component.
- Anxiety,
- Asthenia,
- Depression,
- gastro-intestinal disorders associated with anxiety
- agitation.
Contra-Indications of Melitracen
- Hypersensitivity to Melitracen
- Myocardial infarction
- Narrow-angle glaucoma
- Bipolar disorder
- Epilepsy
- Patient on MAOI therapy
- Concomitant use with the large dose of hypnotics
- Geriatric patients with confusion or agitation
- Hypersensitivity to this drug
- Patients with central nervous system depression
- Patients with dementia
- Patients with liver damage, cerebrovascular or renal insufficiency, and severe cardiovascular disorders
- Presence of alcohol, barbiturate, or opiate intoxication
- Psychoneurotic patients
- Severely agitated psychotic patients
Dosage of Melitracen
- Adult:1 – 2 tablet to be taken daily.
- Adult: Initially, 25 mg bid-tid, gradually increased to 225 mg daily if necessary.
- Elderly: Initially, 25 mg daily.
Side Effects of Melitracen
The most common
- Weakness
- Drowsiness
- Anxiety
- Insomnia
- Dry mouth.
- Difficulty in breathing
- Headache
- Weight gain
- Nausea
- Upset stomach
- Decreased appetite
- Diarrhea
More common
- Sweating
- Blurred vision
- Dizziness.
- slower heart rate
- change in sex drive or performance
- diarrhea
- dry eyes
- hair loss
- nausea
- weakness or tiredness
Common
- Cough producing mucus
- difficulty with breathing
- tightness in the chest
- Abdominal or stomach pain and tenderness
- blistering, peeling, or loosening of the skin
- Anxiety
- dry mouth
- irritability
- shaking
- sleepiness or unusual drowsiness
- trouble sleeping
- unusual dreams blood in the urine
- Decreased appetite
Drug Interactions of Melitracen
Melitracen may interact with following drugs, supplements & may change the efficacy of drugs
- antihistamines (e.g, cetirizine, doxylamine, diphenhydramine, hydroxyzine, loratadine)
- antipsychotics (e.g., chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
- antiseizure medications (e.g., clobazam, phenobarbital, phenytoin, valproic acid, zonisamide)
- aripiprazole
- “azole” antifungals (e.g., itraconazole, ketoconazole, voriconazole)
- baclofen
- barbiturates (e.g., butalbital, pentobarbital, phenobarbital)
- benzodiazepines (e.g., alprazolam, diazepam, lorazepam)
- domperidone
- famotidine
- gabapentin
- ipratropium
- ketotifen
- levodopa
- macrolide antibiotics (e.g., azithromycin, clarithromycin, erythromycin)
- magnesium sulfate
- methylphenidate
- mirtazapine
- monoamine oxidase inhibitors (MAOIs; e.g., moclobemide, rasagiline, selegiline, tranylcypromine)
- muscle relaxants (e.g., cyclobenzaprine, methocarbamol, orphenadrine)
- orphenadrine
- quinolone antibiotics (e.g., levofloxacin, norfloxacin, moxifloxacin)
- selective serotonin reuptake inhibitors (SSRIs; e.g., paroxetine, fluoxetine, citalopram)
- serotonin antagonists (anti-emetic medications; e.g., granisetron, ondansetron)
- sotalol
- tapentadol
- thiazide diuretics (water pills; e.g., hydrochlorothiazide, indapamide, )
- thioridazine
- tolterodine
- tramadol
- trimethoprim
- tricyclic antidepressants (e.g., amitriptyline, clomipramine, desipramine, trimipramine)
- “triptan” migraine medications (e.g., eletriptan, sumatriptan)
- tryptophan
- tyrosine kinase inhibitors (e.g., dasatinib, imatinib, nilotinib, sunitinib)
- vardenafil
Pregnancy & Lactation of Melitracen
FDA Pregnancy category C
Pregnancy
This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately. Newborn babies who have been exposed to this medication in the last 3 months of pregnancy have experienced withdrawal symptoms after birth.
Lactation
This medication passes into breast milk. If you are a breastfeeding mother and are taking flupenthixol, it may affect your baby. Talk to your doctor about whether you should breastfeeding-feeding.
References
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