Moclobemide should be co-administered with selective serotin reuptake inhibitors and tricyclic antidepressants that have serotonin reuptake inhibitory (SSRI) activity.

Moclobemide therapy should be altered only after elapse of time period equal to 4 to 5 half- lives  of the SSRI drug or any active metabolic.

However, treatment with other tricyclic antidepressants can be inhibited without a wash out period.
Severe drug interactions can be anticipated between reversible monoamime oxidase inhibitors and opiates owing to the inhibitotary action of the opiates on neutronal serotonin reuptake.

Avoid meperidine and codeine in patients taking moclobemide.
 Excercise caution while using morphine and fentanyl with moclobemide.

 

Hepatic failure and cholelitiasis, dizziness, nausea, insomnia or sleep disturbances, dry mouth,tremor, sweating, constipation, headcahe, anxiety, agitation, excitement, fear, irritability, panic and restlessness.

 

Acute confusional states,
Pheochromocytoma
Hypersensitivity to moclbemide
Schizophrenia and schizoaffective disorders

Special Precautions:
Not recommended for use in neonates and in children.
Benefitsof continuing therapy in nursing mothers should be evaluated against possible risks to the child.

Safety and efficacy on pregnant women not established
Daily dose should be reduced to one half or one third of usual dose in patients with liver diseases.

 

Initially 300mg daily in two divided doses after meals
Max 600mg daily

social pnobia-
300mg daily for 3 days then 600mg daily in 2 divided doses for 8-12 weeks. Then assess

Impaired hepatic function- reduce by 1/2 to 1/3 the normal dose

Children - not recommended

 

Not recommended  for use in neonates and children
Dose to reduced in patients suffering from liver disease.

 

Pharmacology:
The funtionaal forms of MAO enzymes are MAO-A and MAO-B based  on the difference in substrate affinity, inhibitor specificitivity, and tissue distribution. MOA-A preferentially demainates adrenaline , nor-adrenaline and serotonin, while MAO-B is more selective for 2-phenylamine and benzylamine. The exact mode of action of moclobemide  is not clear. It is thought that initially it binds to the receptor in a competitive manner and the it proceeds through a mixed competitive/no compettitive phase and finally becomes non competitive.

Pharmacokinetics:
Moclobemide is eliminated by hepatic metabolism. !9 metabolites are formed in the liver predominantly by morpholine-N-oxidation and morpholine-O-Oxidation. Less than 0.5% of the parent compound is excreted in the urine after oral administration.

 

Safety and efficacy in pregnancy not established