Neocipran 50

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.

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Uses of Neocipran 50
Fibromyalgia
Depression
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.
Quick Tips
Neocipran 50 helps in treating depression and anxiety.
It may also be used to treat nerve pain from diabetes and some other forms of chronic pain.
It may take 2 to 4 weeks for Neocipran 50 to start working. Keep taking it as prescribed.
It may cause dizziness and sleepiness. Do not drive or do anything requiring concentration until you know how it affects you.
Avoid consuming alcohol when taking Neocipran 50 as it may cause excessive drowsiness and increase the risk of liver damage.
It may cause a sensation of restlessness, especially when you first start taking it. Inform your doctor if this happens to you.
Talk to your doctor if you notice sudden mood changes or develop suicidal thoughts.
Do not stop taking the medication suddenly without talking to your doctor.
Brief Description
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

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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.

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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).

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