Denapranil Uses

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What is Denapranil?

Denapranil is used to treat obsessive compulsive disorder (OCD). OCD is a nervous condition where a person has recurring thoughts or ideas, or does repetitive things because they are anxious.

Denapranil is a tricyclic antidepressant (TCA). It is thought to work in the brain by increasing the activity of the chemical serotonin.

Denapranil is available only with your doctor's prescription.

Denapranil indications

An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.
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For the treatment of depression. Denapranil also appears to have a mild sedative effect which may be helpful in alleviating the anxiety component often accompanying depression.

For the treatment of obsessions and compulsions in patients with obsessive compulsive disorder (OCD). The obsessions and compulsions must cause marked distress, be time-consuming, or significantly interfere with social or occupational functioning.

How should I use Denapranil?

Use Denapranil as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Ask your health care provider any questions you may have about how to use Denapranil.

Uses of Denapranil in details

There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.
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Use: Labeled Indications

Obsessive-compulsive disorder: Treatment of obsessive-compulsive disorder

Off Label Uses

Major depressive disorder

Data from randomized, double-blind studies supports the use of Denapranil in the treatment of major depressive disorder. Additional trials may be necessary to further define the role of Denapranil in this condition.

According to the American Psychiatric Association treatment guidelines, Denapranil is effective and recommended for the management of major depressive disorder. Although the WFSBP treatment guidelines also recommend Denapranil, particularly for patients with severe depression or concomitant obsessive-compulsive disorder, the guidelines recommend prescribing a limited supply for severely depressed patients at risk of overdose.

Panic disorder

Data from randomized, double-blind, placebo-controlled studies supports the use of Denapranil in the management of panic disorder with or without agoraphobia to decrease severity of anxiety and phobias, as well as severity and frequency of panic attacks. Additional trials may be necessary to further define the role of Denapranil in this condition.

Based on the American Psychiatric Association guidelines for the treatment of panic disorder, selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), and benzodiazepines all have roughly comparable efficacy in the treatment of panic disorder, but SSRIs are likely to have the most favorable balance of efficacy and adverse effects for most patients. Based on the Canadian Psychiatric Association guidelines for the management of anxiety disorders, TCAs like Denapranil are second-line choices for panic disorder. Based on the World Federation of the Societies of Biological Psychiatry guidelines for the management of anxiety disorders, TCAs are recommended in panic disorder in patients who have not responded to SSRIs or SNRIs.

Denapranil description

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Denapranil, the 3-chloro analog of imipramine, is a dibenzazepine-derivative tricyclic antidepressant (TCA). TCAs are structurally similar to phenothiazines. They contain a tricyclic ring system with an alkyl amine substituent on the central ring. In non-depressed individuals, Denapranil does not affect mood or arousal, but may cause sedation. In depressed individuals, Denapranil exerts a positive effect on mood. TCAs are potent inhibitors of serotonin and norepinephrine reuptake. Tertiary amine TCAs, such as Denapranil, are more potent inhibitors of serotonin reuptake than secondary amine TCAs, such as nortriptyline and desipramine. TCAs also down-regulate cerebral cortical β-adrenergic receptors and sensitize post-synaptic serotonergic receptors with chronic use. The antidepressant effects of TCAs are thought to be due to an overall increase in serotonergic neurotransmission. TCAs also block histamine-H1 receptors, α1-adrenergic receptors and muscarinic receptors, which accounts for their sedative, hypotensive and anticholinergic effects (e.g. blurred vision, dry mouth, constipation, urinary retention), respectively. See toxicity section below for a complete listing of side effects. Denapranil may be used to treat obsessive-compulsive disorder and disorders with an obsessive-compulsive component (e.g. depression, schizophrenia, Tourette’s disorder). Unlabeled indications include panic disorder, chronic pain (e.g. central pain, idiopathic pain disorder, tension headache, diabetic peripheral neuropathy, neuropathic pain), cataplexy and associated narcolepsy, autistic disorder, trichotillomania, onchophagia, stuttering, premature ejaculation, and premenstrual syndrome. Denapranil is rapidly absorbed from the gastrointestinal tract and demethylated in the liver to its primary active metabolite, desmethylclomipramine.

Denapranil dosage

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Denapranil Dosage

Generic name: Denapranil HYDROCHLORIDE 25mg

Dosage form: capsule

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

The treatment regimens described below are based on those used in controlled clinical trials of Denapranil in 520 adults, and 91 children and adolescents with OCD. During initial titration, Denapranil should be given in divided doses with meals to reduce gastrointestinal side effects. The goal of this initial titration phase is to minimize side effects by permitting tolerance to side effects to develop or allowing the patient time to adapt if tolerance does not develop.

Because both CMI and its active metabolite, DMI, have long elimination half-lives, the prescriber should take into consideration the fact that steady-state plasma levels may not be achieved until 2 to 3 weeks after dosage change. Therefore, after initial titration, it may be appropriate to wait 2 to 3 weeks between further dosage adjustments.

Initial Treatment/Dose Adjustment (Adults)

Treatment with Denapranil should be initiated at a dosage of 25 mg daily and gradually increased, as tolerated, to approximately 100 mg during the first 2 weeks. During initial titration, Denapranil should be given in divided doses with meals to reduce gastrointestinal side effects. Thereafter, the dosage may be increased gradually over the next several weeks, up to a maximum of 250 mg daily. After titration, the total daily dose may be given once daily at bedtime to minimize daytime sedation.

Initial Treatment/Dose Adjustment (Children and Adolescents)

As with adults, the starting dose is 25 mg daily and should be gradually increased (also given in divided doses with meals to reduce gastrointestinal side effects) during the first 2 weeks, as tolerated, up to a daily maximum of 3 mg/kg or 100 mg, whichever is smaller. Thereafter, the dosage may be increased gradually over the next several weeks up to a daily maximum of 3 mg/kg or 200 mg, whichever is smaller. As with adults, after titration, the total daily dose may be given once daily at bedtime to minimize daytime sedation.

Maintenance/Continuation Treatment (Adults, Children, and Adolescents)

While there are no systematic studies that answer the question of how long to continue Denapranil, OCD is a chronic condition and it is reasonable to consider continuation for a responding patient. Although the efficacy of Denapranil after 10 weeks has not been documented in controlled trials, patients have been continued in therapy under double-blind conditions for up to 1 year without loss of benefit. However, dosage adjustments should be made to maintain the patient on the lowest effective dosage, and patients should be periodically reassessed to determine the need for treatment. During maintenance, the total daily dose may be given once daily at bedtime.

Switching a Patient To or From a Monoamine Oxidase Inhibitor (MAOI) Intended to Treat Psychiatric Disorders

At least 14 days should elapse between discontinuation of an MAOI intended to treat psychiatric disorders and initiation of therapy with Denapranil. Conversely, at least 14 days should be allowed after stopping Denapranil before starting an MAOI intended to treat psychiatric disorders.

Use of Denapranil With Other MAOIs, Such as Linezolid or Methylene Blue

Do not start Denapranil in a patient who is being treated with linezolid or intravenous methylene blue because there is increased risk of serotonin syndrome. In a patient who requires more urgent treatment of a psychiatric condition, other interventions, including hospitalization, should be considered.

In some cases, a patient already receiving Denapranil therapy may require urgent treatment with linezolid or intravenous methylene blue. If acceptable alternatives to linezolid or intravenous methylene blue treatment are not available and the potential benefits of linezolid or intravenous methylene blue treatment are judged to outweigh the risks of serotonin syndrome in a particular patient, Denapranil should be stopped promptly, and linezolid or intravenous methylene blue can be administered. The patient should be monitored for symptoms of serotonin syndrome for two weeks or until

24 hours after the last dose of linezolid or intravenous methylene blue, whichever comes first. Therapy with Denapranil may be resumed 24 hours after the last dose of linezolid or intravenous methylene blue.

The risk of administering methylene blue by non-intravenous routes (such as oral tablets or by local injection) or in intravenous doses much lower than 1 mg/kg with Denapranil is unclear. The clinician should, nevertheless, be aware of the possibility of emergent symptoms of serotonin syndrome with such use.

More about Denapranil (Denapranil)

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Denapranil interactions

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What other drugs will affect Denapranil?

drugs used to treat an over-active thyroid, MAO inhibitors (e.g., furazolidone, linezolid, phenelzine, selegiline, tranylcypromine), other tranquilizers, medicines that make you excited, high blood pressure drugs, narcotic pain medications (e.g., codeine), SSRI antidepressants (e.g., fluoxetine, fluvoxamine), other drugs you use (both prescription and non- prescription), St John’s wort. Do not start or stop any medicine without doctor or pharmacist approval.

Denapranil side effects

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What are the possible side effects of Denapranil?

This medication may cause drowsiness, dizziness, increased sun sensitivity or blurred vision. Use caution performing tasks that require alertness. This medication may initially cause dizziness and lightheadedness when rising too quickly from a sitting or lying position. Change positions and get out of bed slowly. Other side effects may include heartburn, weight gain, dry mouth, strange taste in mouth, anxiety, restlessness or sweating. These effects should subside as your body adjusts to the medication. Inform your doctor if they continue or become bothersome. Notify your doctor if you develop: chest pain, a rapid heart rate, difficulty urinating, nightmares, ringing in the ears, excessive sedation, uncoordinated movements, fainting. Males may experience sexual dysfunction while taking this medication. In the unlikely event you have a serious allergic reaction to this drug, seek medical attention immediately. Symptoms of a serious allergic reaction include: rash, itching, swelling, severe dizziness, trouble breathing. If you notice other effects not listed above, contact your doctor or pharmacist.

Denapranil contraindications

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What is the most important information I should know about Denapranil?

Patients who have known hypersensitivity to the drug or have known hypersensitivity to tricyclic antidepressants belonging to the dibenzazepine group.

Denapranil should not be given in conjunction with or within 14 days of treatment with a MAO inhibitor. Hypertensive crises, hyperactivity, hyperpyrexia, spasticity, severe convulsions or coma, and death have been reported in patients receiving such combinations.

It is contraindicated during the acute recovery phase following myocardial infarction and in the presence of acute congestive heart failure.

Denapranil is contraindicated in patients with existing liver or kidney damage and should not be administered to patients with a history of blood dyscrasias.

Denapranil is contraindicated in patients with glaucoma, as the condition may be aggravated due to the atropine-like effects of the drug.

Active ingredient matches for Denapranil:

Clomipramine HCl in Malaysia.


Unit description / dosage (Manufacturer)Price, USD
Denapranil 25 mg x 20 x 10's

List of Denapranil substitutes (brand and generic names):

References

  1. PubChem. "clomipramine". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
  2. DrugBank. "clomipramine". http://www.drugbank.ca/drugs/DB01242 (accessed September 17, 2018).
  3. DTP/NCI. "clomipramine: The NCI Development Therapeutics Program (DTP) provides services and resources to the academic and private-sector research communities worldwide to facilitate the discovery and development of new cancer therapeutic agents.". https://dtp.cancer.gov/dtpstandard/s... (accessed September 17, 2018).

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