Nurses Compass
Drug Guide
Mazindol
Classification
Therapeutic: Appetite suppressant, Central Nervous System stimulant
Pharmacological: Noradrenaline-dopamine reuptake inhibitor
FDA Approved Indications
- Short-term management of obesity associated with comorbidities
Mechanism of Action
Mazindol inhibits the reuptake of norepinephrine and dopamine in the central nervous system, leading to appetite suppression and reduced food intake.
Dosage and Administration
Adult: Typically 1 mg twice daily before meals; dosage may be adjusted based on response and tolerability.
Pediatric: Not approved for pediatric use.
Geriatric: Use with caution; start at lower doses due to potential for increased sensitivity and adverse effects.
Renal Impairment: Use with caution; dose adjustments may be necessary.
Hepatic Impairment: Data lacking; use caution.
Pharmacokinetics
Absorption: Well absorbed orally.
Distribution: Widely distributed; crosses the blood-brain barrier.
Metabolism: Minimal hepatic metabolism.
Excretion: Primarily renal excretion.
Half Life: Approximately 10 hours.
Contraindications
- History of cardiovascular disease, hypertension, hyperthyroidism, acute mood disorders, history of drug abuse.
Precautions
- Monitor blood pressure, heart rate; use cautiously in patients with psychiatric disorders, history of drug dependence, or substance abuse.
Adverse Reactions - Common
- Insomnia (Common)
- Dry mouth (Common)
- Increased blood pressure (Common)
- Palpitations (Common)
Adverse Reactions - Serious
- Arrhythmias (Rare)
- Seizures (Rare)
- Psychosis or paranoia (Rare)
Drug-Drug Interactions
- MAO inhibitors (risk of hypertensive crisis)
- Other sympathomimetics
- Antihypertensive agents (may affect blood pressure)
Drug-Food Interactions
- None specifically identified
Drug-Herb Interactions
- St. John's Wort (potential for increased side effects)
Nursing Implications
Assessment: Monitor blood pressure, heart rate, mental status, and signs of dependence.
Diagnoses:
- Risk for cardiovascular side effects
- Risk for psychological dependence
Implementation: Administer as prescribed; monitor for adverse effects; educate patient on potential for dependence.
Evaluation: Assess weight loss, behavior changes, cardiovascular stability.
Patient/Family Teaching
- Take medication exactly as prescribed.
- Report to healthcare provider if experiencing chest pain, rapid heartbeat, or psychological symptoms.
- Avoid alcohol and other CNS depressants.
- Do not discontinue abruptly.
Special Considerations
Black Box Warnings:
- Potential for severe psychological or dependence issues.
Genetic Factors: None well established.
Lab Test Interference: May affect blood pressure readings.
Overdose Management
Signs/Symptoms: Severe agitation, hallucinations, hyperactivity, hypertension, tachycardia, seizures.
Treatment: Supportive care, monitoring vital signs, benzodiazepines for agitation or seizures, activated charcoal if ingestion is recent, consultation with poison control.
Storage and Handling
Storage: Store at room temperature, away from moisture, heat, and light.
Stability: Stable under recommended storage conditions.