If you are:
Only When Necessary: NON-TERATOGENIC COMPLICATIONS (RESP, GI,CNS) WITH EXPOSURE DURING 3RD TRIMESTER
Only When Necessary: RISK OF PERSISTENT PULM HTN AFTER 20 WKS; NEONATE BEHAVIOR SYNDR 3RD TRIMESTER
Precaution: LIMITED DATA SUGGEST LOW LEVELS EXCRETED RESULTING IN INFANT SEDATION
Precaution: CAN CAUSE COLIC, IRRITABILITY, FEEDING AND SLEEP DISORDERS, SLOW WEIGHT GAIN
An adult over 60:
management or monitoring precaution: Neuro/Psych-Higher risk of tardive dyskinesia in the elderly. Anticholinergic effects cause sedation, worsen cognitive impairment and increase fall risk. Increased risk of death in senile dementia. Maximum of 7.5mg/day. Cardiovascular-May cause orthostatic hypotension at higher doses. Gastrointestinal-May cause or worsen pre-existing constipation. Genitourinary-Best avoided in patients with urinary retention from any cause.
management or monitoring precaution: Hepatic-Accumulation may be greater in the elderly due to long half-life. Start at lower doses and titrate upward more slowly. Endocrine-May exacerbate or cause SIADH or hyponatremia. Monitor sodium level closely when starting or changing dosage. Cardiovascular-Risk of QT prolongation. Caution with underlying cardiac condition, electrolyte abnormalities.
Giving Symbyax to a child under 12:
Severe Precaution: Safety and efficacy not established and not approved age < 7 years. May affect growth rate.
management or monitoring precaution: Increased risk of sedation, hyperlipidemia and increased prolactin levels. Monitor weight and liver functions tests.
Severe Precaution: Monitor growth and behavior. Possible aggression, mania, suicidal ideation. Reports of hyperkinesia, agitation, personality disorder.
Severe Precaution: Safety and efficacy not established age less than 10 years for combination with fluoxetine.