Drug Action
Moclobemide is reported to act by reversible inhibition of monoamine oxidase type A (it is therefore termed a RIMA).
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Drug reference
Moclobemide is reported to act by reversible inhibition of monoamine oxidase type A (it is therefore termed a RIMA).
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Depressive illness ▶BY MOUTH ▶Adult: Initially 300 mg daily in divided doses, adjusted according to response; usual dose 150–600 mg daily, dose to be taken after food Social anxiety disorder ▶BY MOUTH ▶Adult: Initially 300 mg daily for 3 days, then increased to 600 mg daily in 2 divided doses continued for 8–12 weeks to assess efficacy
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DUE TO INTERACTIONS ▶Manufacturer advises reduce dose to half or one-third of the usual dose with concurrent use of cimetidine.
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Acute confusional states. phaeochromocytoma
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Avoid in agitated or excited patients (or give with sedative for up to 2–3 weeks). may provoke manic episodes in bipolar disorders. thyrotoxicosis
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→Appendix 1: moclobemide
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▶Common or very common Anxiety. constipation. diarrhoea . dizziness. dry mouth. headache. hypotension. irritability. nausea. paraesthesia. skin reactions. sleep disorder. vomiting ▶Uncommon Asthenia. confusion. flushing. oedema. suicidal tendencies. taste altered. visual impairment ▶Rare or very rare Appetite decreased. delusions. hyponatraemia. serotonin syndrome
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Safety in pregnancy has not been established—manufacturer advises avoid unless there are compelling reasons.
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Amount too small to be harmful, but patient information leaflet advises avoid.
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Manufacturer advises caution in severe impairment (risk of decreased metabolism). Dose adjustments Manufacturer advises dose reduction to half or one-third of the daily dose in severe impairment,
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There can be variation in the licensing of different medicines containing the same drug. Forms available from special-order manufacturers include: oral suspension Tablet CAUTIONARY AND ADVISORY LABELS 10, 21 ▶Moclobemide (Non-proprietary) Moclobemide 150 mg Moclobemide 150mg tablets | 30 tablet P £27.63 DT = £28.25 Moclobemide 300 mg Moclobemide 300mg tablets | 30 tablet P £19.20 DT = £13.99 ▶Manerix (Mylan) Moclobemide 150 mg Manerix 150mg tablets | 30 tablet P £9.33 DT = £28.25 Moclobemide 300 mg Manerix 300mg tablets | 30 tablet P £13.99 DT = £13.99 ANTIDEPRESSANTS › NORADRENALINE REUPTAKE INHIBITORS
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Withdrawal effects may occur within 5 days of stopping treatment with antidepressant drugs; they are usually mild and self-limiting, but in some cases may be severe. The risk of withdrawal symptoms is increased if the antidepressant is stopped suddenly after regular administration for 8 weeks or more. The dose should preferably be reduced gradually over about 4 weeks, or longer if withdrawal symptoms emerge (6 months in patients who have been on long-term maintenance treatment).
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Moclobemide is claimed to cause less potentiation of the pressor effect of tyramine than the traditional (irreversible) MAOIs, but patients should avoid consuming large amounts of tyramine-rich food (such as mature cheese, yeast extracts and fermented soya bean products).
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Initially 300 mg daily in divided doses, adjusted
First-line fragment. Read the complete Indications and Dose section above.
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Initially 300 mg daily for 3 days, then increased
First-line fragment. Read the complete Indications and Dose section above.
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