Home Drug Guide Gepirone Hydrochloride

Drug Guide

Generic Name

Gepirone Hydrochloride

Brand Names Exxua

Classification

Therapeutic: Antidepressant, Anxiolytic

Pharmacological: Serotonin Receptor Modulator

FDA Approved Indications

Generalized Anxiety Disorder (GAD)

Mechanism of Action

Gepirone is a selective partial agonist at the 5-HT1A serotonin receptors, which modulates serotonergic activity in the brain, leading to anxiolytic and antidepressant effects.

Dosage and Administration

Adult: Typically, 10 mg twice daily, titrated up based on response and tolerability. Always follow prescribing guidelines.

Pediatric: Not approved for pediatric use.

Geriatric: Start at the lower end of dosing; monitor closely due to increased sensitivity and comorbidities.

Renal Impairment: Use with caution; consider dose adjustments based on renal function.

Hepatic Impairment: Use with caution; hepatic impairment may increase plasma concentrations.

Pharmacokinetics

Absorption: Well absorbed with oral administration.

Distribution: Widely distributed; crosses the blood-brain barrier.

Metabolism: Hepatically metabolized via CYP450 enzymes; specific pathways not fully characterized.

Excretion: Primarily in urine as metabolites.

Half Life: Approximately 6-8 hours.

Contraindications

Hypersensitivity to gepirone or related compounds

Precautions

Use cautiously in patients with hepatic impairment, history of seizure disorders, or concurrent MAOI use. Avoid in pregnancy and lactation unless benefits outweigh risks.

Adverse Reactions - Common

Nausea (Common)
Dizziness (Common)
Headache (Common)

Adverse Reactions - Serious

Serotonin syndrome (Rare)
Seizures (Rare)
Hepatotoxicity (Rare)

Drug-Drug Interactions

CYP450 inhibitors or inducers may alter gepirone levels.
Concurrent use with other serotonergic agents may increase the risk of serotonin syndrome.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for efficacy and adverse effects, including liver function tests and signs of serotonin syndrome.

Diagnoses:

Risk for injury related to dizziness or hypotension

Implementation: Administer as prescribed; educate patient about adherence and side effects.

Evaluation: Assess symptom improvement and adverse reactions.

Patient/Family Teaching

Take medication exactly as prescribed.
Report any signs of serotonin syndrome (confusion, hallucinations, seizures).
Avoid alcohol and CNS depressants.
Notify provider of any worsening symptoms or adverse effects.

Special Considerations

Black Box Warnings:

Serotonin syndrome risk if combined with other serotonergic drugs.
Potential for hepatic impairment.

Genetic Factors: No specific pharmacogenomic data available.

Lab Test Interference: May slightly alter liver function test results.

Overdose Management

Signs/Symptoms: Dizziness, nausea, vomiting, somnolence, seizures in severe cases.

Treatment: Supportive care; monitor vital signs; hemodialysis if necessary for severe overdose.

Storage and Handling

Storage: Store at room temperature, 15-30°C (59-86°F).

Stability: Stable when stored properly; check expiration date.