Home Drug Guide Reserpine

Drug Guide

Generic Name

Reserpine

Brand Names Serpasil, Rau-sed, Sandril, Serpanray, Serpate, Hiserpia, Serpivite, Serpalan

Classification

Therapeutic: Antihypertensive / Antipsychotic

Pharmacological: Indolamine depleting agent, Adrenergic neuron blocker

FDA Approved Indications

Hypertension
Schizophrenia (less common now due to side effects)

Mechanism of Action

Reserpine depletes synaptic vesicles of catecholamines (dopamine, norepinephrine) and serotonin by inhibiting vesicular Monoamine Transporter 2 (VMAT2), leading to decreased sympathetic tone and sedative effects.

Dosage and Administration

Adult: Typically 0.25 to 0.5 mg twice daily, titrated according to response.

Pediatric: Not generally recommended for children.

Geriatric: Start at lower doses due to increased sensitivity; monitor closely.

Renal Impairment: Use with caution; dose adjustments may be necessary.

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

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed in body tissues.

Metabolism: Metabolized in the liver.

Excretion: Excreted primarily via the urine.

Half Life: Approximately 24 hours.

Contraindications

Depression (may worsen symptoms)
Peptic ulcer
Asthma

Precautions

History of depression or suicidal ideation
History of severe allergies
Use cautiously in patients with Parkinson’s disease, urinary obstruction, or cardiovascular disease.

Adverse Reactions - Common

Sedation or drowsiness (Common)
Nasal congestion (Common)
GI disturbances (nausea, diarrhea) (Common)

Adverse Reactions - Serious

Depression (Less common but significant)
Extrapyramidal symptoms (Rare)
Orthostatic hypotension (Common)

Drug-Drug Interactions

Monoamine oxidase inhibitors (risk of hypertensive crisis)
Other antihypertensives (potentiation)
Tricyclic antidepressants (may reduce effectiveness)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood pressure, mental status, and signs of depression.

Diagnoses:

Risk for decreased cardiac output
Risk for mood disturbances

Implementation: Administer as prescribed, usually before meals or at bedtime; monitor for side effects.

Evaluation: Effectiveness in lowering blood pressure, mood stability, and adverse reactions.

Patient/Family Teaching

Take exactly as prescribed.
Report symptoms of depression or mood changes.
Avoid abrupt discontinuation—taper under medical supervision.
Monitor blood pressure regularly.
Be cautious about driving or operating machinery until effects are known.

Special Considerations

Black Box Warnings:

Potential to cause severe depression and suicidal ideation.

Genetic Factors: Genetic variation in drug metabolism may influence response.

Lab Test Interference: May alter blood counts or liver function tests.

Overdose Management

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

Treatment: Supportive care, IV fluids, vasopressors if needed, gastric lavage in early ingestion, activated charcoal.

Storage and Handling

Storage: Store at room temperature, away from moisture and light.

Stability: Stable under recommended conditions.