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Melitracen; Uses, Dosage, Side Effects, Interactions

Melitracen is a tricyclic antidepressant respectively, for the treatment of depression and anxiety. In addition to single drug preparations, it is also available as Deanxit, a combination product containing both melitracen and flupentixol

Mechanism of action of Melitracen

Flupentixol inhibits dopamine-mediated effects by blocking postsynaptic dopamine receptors in the CNS. Melitracen is a TCA with anxiolytic properties. At low doses, it has to activate properties. It is also a bipolar thymoleptic.
Absorption: Flupentixol: Readily absorbed in the GI tract.
Distribution: Flupentixol: >95% bound to plasma proteins; widely distributed in the body and crosses the blood-brain barrier.
Metabolism: Flupentixol: Extensively hepatic metabolism.
Excretion: Flupentixol: Excreted in urine and feces in the form of many metabolites.

Indications of Melitracen

Depressive illness
Anxiety or bipolar illness. Its second component, melitracen acts against bipolar illnesses.
Psychogenic depression
Menopausal depression, where nothing else works
Long lasting myogenic headache
Resistant migraines
Certain gastrointestinal disturbances which have a neurological component.
Anxiety,
Asthenia,
Depression,
gastro-intestinal disorders associated with anxiety
agitation.

Contra-Indications of Melitracen

Hypersensitivity to Melitracen
Myocardial infarction
Narrow-angle glaucoma
Bipolar disorder
Epilepsy
Patient on MAOI therapy
Concomitant use with the large dose of hypnotics
Geriatric patients with confusion or agitation
Hypersensitivity to this drug
Patients with central nervous system depression
Patients with dementia
Patients with liver damage, cerebrovascular or renal insufficiency, and severe cardiovascular disorders
Presence of alcohol, barbiturate, or opiate intoxication
Psychoneurotic patients
Severely agitated psychotic patients

Dosage of Melitracen

Adult:1 – 2 tablet to be taken daily.

Depression

Adult: Initially, 25 mg bid-tid, gradually increased to 225 mg daily if necessary.
Elderly: Initially, 25 mg daily.

Side Effects of Melitracen

The most common

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More common

Sweating
Blurred vision
Dizziness.
slower heart rate
change in sex drive or performance
diarrhea
dry eyes
hair loss
nausea
weakness or tiredness

Common

Cough producing mucus
difficulty with breathing
tightness in the chest
Abdominal or stomach pain and tenderness
blistering, peeling, or loosening of the skin
Anxiety
dry mouth
irritability
shaking
sleepiness or unusual drowsiness
trouble sleeping
unusual dreams blood in the urine
Decreased appetite

Drug Interactions of Melitracen

Melitracen may interact with following drugs, supplements & may change the efficacy of drugs

antihistamines (e.g, cetirizine, doxylamine, diphenhydramine, hydroxyzine, loratadine)
antipsychotics (e.g., chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
antiseizure medications (e.g., clobazam, phenobarbital, phenytoin, valproic acid, zonisamide)
aripiprazole
“azole” antifungals (e.g., itraconazole, ketoconazole, voriconazole)
baclofen
barbiturates (e.g., butalbital, pentobarbital, phenobarbital)
benzodiazepines (e.g., alprazolam, diazepam, lorazepam)
domperidone
famotidine
gabapentin
ipratropium
ketotifen
levodopa
macrolide antibiotics (e.g., azithromycin, clarithromycin, erythromycin)
magnesium sulfate
methylphenidate
mirtazapine
monoamine oxidase inhibitors (MAOIs; e.g., moclobemide, rasagiline, selegiline, tranylcypromine)
muscle relaxants (e.g., cyclobenzaprine, methocarbamol, orphenadrine)
orphenadrine
quinolone antibiotics (e.g., levofloxacin, norfloxacin, moxifloxacin)
selective serotonin reuptake inhibitors (SSRIs; e.g., paroxetine, fluoxetine, citalopram)
serotonin antagonists (anti-emetic medications; e.g., granisetron, ondansetron)
sotalol
tapentadol
thiazide diuretics (water pills; e.g., hydrochlorothiazide, indapamide, )
thioridazine
tolterodine
tramadol
trimethoprim
tricyclic antidepressants (e.g., amitriptyline, clomipramine, desipramine, trimipramine)
“triptan” migraine medications (e.g., eletriptan, sumatriptan)
tryptophan
tyrosine kinase inhibitors (e.g., dasatinib, imatinib, nilotinib, sunitinib)
vardenafil

Pregnancy & Lactation of Melitracen

FDA Pregnancy category‎ ‎C

Pregnancy

This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately. Newborn babies who have been exposed to this medication in the last 3 months of pregnancy have experienced withdrawal symptoms after birth.

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Lactation

This medication passes into breast milk. If you are a breastfeeding mother and are taking flupenthixol, it may affect your baby. Talk to your doctor about whether you should breastfeeding-feeding.