Dosing and uses of Serpasil (reserpine)
Adult dosage forms and strengths
tablet
- 0.1mg
- 0.25mg
Hypertension
InitiaL
- 0.5 mg daily for 1 or 2 weeks
Maintenance
- 0.1-0.25 mg PO qDay
- Use higher dosages cautiously occurrence of mental depression or other adverse reactions may increase
Psychiatric Disorders
0.5 mg daily, but may range from 0.1 to 1 mg
Pediatric dosage forms and strengths
tablet
- 0.1mg
- 0.25mg
Hypertension
0.02 mg/kg/d POqD or div BID, no more than 0.25 mg/d
Geriatric dosage forms and strengths
Adverse CNS effects; may cause bradycardia and orthostatic hypotension; not recommended as routine treatment for hypertension (Beers criteria)
0.05 mg PO qDay; may increase by 0.05 mg after 1 week as needed; not to exceed 0.1 mg/day
Serpasil (reserpine) adverse (side) effects
Frequency not defined
Angina
Bradycardia
Syncope
Dizziness
Depression
Lethargy
Nightmare
Tardive dyskinesia
GI hypersecretion
Impotence
Nasal congestion
Warnings
Contraindications
Hypersensitivity, active peptic ulcer, ulcerative colitis, history of depression, history of gallstones; electroconvulsive treatment within 1 week
MAOIs: discontinue several days before starting reserpine therapy
Avoid during breast-feeding
Cautions
Asthma
History of gall stones, PUD, ulcerative colitis
Breastfeeding
Pregnancy and lactation
Pregnancy category: C
Lactation: unsafe; excreted into breast milk
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Serpasil (reserpine)
Mechanism of action
Peripheral adrenergic neuron antagonist via depletion of tissue store of catecholamines resulting in bradycardia
Absorption
Bioavailability: 30-40%
Duration: 1-6 wk
Distribution
Protein binding: 96%
Metabolism
Extensively metabolized in the liver
Metabolites: trimethylbenzoic acid, methyl reserpate (inactive)
Elimination
Half-Life: 50-100 hr
Excretion: Feces 60%; urine 12%
