Home Drug Guide Rauwolfia serpentina

Drug Guide

Generic Name

Rauwolfia serpentina

Brand Names Raudixin, Rauval, Wolfina, Hiwolfia, Koglucoid, Rauserpin, Hyserpin

Classification

Therapeutic: Antihypertensive, Sedative

Pharmacological: Alkaloid, Reserpine-containing

FDA Approved Indications

N/A

Mechanism of Action

Reserpine, an alkaloid compound in Rauwolfia serpentina, depletes catecholamines and serotonin from central and peripheral neurons, leading to decreased blood pressure and sedative effects.

Dosage and Administration

Adult: Typically, 0.1 to 0.5 mg daily, titrated based on response.

Pediatric: Not generally recommended due to lack of safety data.

Geriatric: Start at lower doses due to increased sensitivity and risk of hypotension.

Renal Impairment: Adjust dosing cautiously; monitor blood pressure.

Hepatic Impairment: Use with caution; no specific adjustments established.

Pharmacokinetics

Absorption: Orally absorbed, but variable due to first-pass metabolism.

Distribution: Distributed widely, crosses the blood-brain barrier.

Metabolism: Metabolized in the liver, primarily by CYP enzymes.

Excretion: Excreted mainly via urine.

Half Life: Approximately 24 hours.

Contraindications

Hypersensitivity to Rauwolfia serpentina or its components.
History of depression.

Precautions

Use with caution in patients with depression, Parkinson's disease, peptic ulcer, asthma, or recent myocardial infarction.
Pregnancy and lactation: Use only if benefit outweighs risk.

Adverse Reactions - Common

Sedation (Common)
Postural hypotension (Common)
Nasal congestion (Less common)

Adverse Reactions - Serious

Depression or worsening mood (Rare)
Bradycardia, heart block (Rare)
Gastrointestinal disturbances (Less common)

Drug-Drug Interactions

Sympathomimetics (may reduce effectiveness)
MAO inhibitors (risk of hypertensive crisis)
Antihypertensives (additive effects)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood pressure, heart rate, mood changes, and signs of depression.

Diagnoses:

Risk for hypotension
Risk for depression
Altered mental status

Implementation: Administer at same time daily, monitor for adverse effects, educate patient on signs of hypotension and depression.

Evaluation: Assess blood pressure response, mental status, and patient adherence.

Patient/Family Teaching

Advise patients to rise slowly to prevent orthostatic hypotension.
Report signs of depression, mood changes, or severe adverse effects.
Do not abruptly discontinue without medical advice.

Special Considerations

Black Box Warnings:

Risk of depression and suicide in some patients.

Genetic Factors: Genetic variations may affect metabolism and response.

Lab Test Interference: May interfere with blood pressure measurements temporarily.

Overdose Management

Signs/Symptoms: Severe hypotension, bradycardia, depression, respiratory depression.

Treatment: Supportive care, activated charcoal if recent ingestion, vasopressors for hypotension, atropine for bradycardia.

Storage and Handling

Storage: Store in a cool, dry place away from light.

Stability: Stable when stored properly; check expiration date.