Apexidone 4 mg ( Risperidone ) 30 film-coated tablets

How to take Apexidone?

Your dose and how often you take Apexidone will depend on the following factors:

age

weight

patient’s health

the health of the patient’s liver

the health of the patient’s kidneys

response to the medicine

Apexidone Dosage

Dosage for severe mental disorder (schizophrenia)

Adult

Recommended: 1-2 mg/day oral dose added after 24 hours of initial dose up to 4-8 mg/day based on patient’s response or 25 mg intramuscular injection every 2 weeks

Initial: 2 mg/day orally in one or two divided doses

Maximum: 16 mg/day orally or 50 mg intramuscular injection every 2 weeks

Children

Recommended: 0.5-1 mg/day oral dose added after 24 hours of initial dose up to 3 mg/day based on patient’s response

Initial: 0.5 mg once daily orally

Maximum: 6 mg/day orally

Older Adults

Recommended: 0.5 mg twice daily dose added to initial dose up to 1-2 mg twice daily based on patient’s response

Initial: 0.5 mg tablet twice daily

Dosage for periods of abnormally elevated mood (bipolar mania)

Adult

Recommended: 1 mg/day oral dose added or decreased after 24 hours of initial dose up to 1-6 mg/day based on patient’s response

Initial: 2-3 mg/day orally once daily

Maximum: 6 mg/day orally

Children

Recommended: 0.5 mg or 1 mg/day oral dose added after 24 hours of initial dose up to 2.5 mg/day based on patient’s response

Initial: 0.5 mg once daily orally

Older Adults

Recommended: 0.5 mg twice daily dose added to initial dose up to 1-2 mg twice daily based on patient’s response

Initial: 0.5 mg tablet twice daily

Dosage for periods of depression and abnormally elevated mood (bipolar I disorder)

Adult

Recommended: 25 mg intramuscular injection every 2 weeks

Maximum: 50 mg intramuscular injection every 2 weeks

Dosage for irritability associated with inability to communicate and interact (autistic disorder)

Children (weighing less than 20 kg or 44.1 lb)

Recommended: 0.5 mg/day orally after 4 days of initial dose and in patients unresponsive to this dose after 14 days add an increment of 0.25 mg/day

Initial: 0.25 mg/day orally once daily

Children (weighing equal to or more than 20 kg or 44.1 lb)

Recommended: 1 mg/day orally after 4 days of initial dose and in patients unresponsive to this dose after 14 days add an increment of 0.5 mg/day

Initial: 0.5 mg/day orally once daily

Dosage for persistent aggression in patients with moderate to severe memory loss

Adult

Recommended: 0.25 mg tablet twice daily may be added to the starting dose every other day. In some patients, 0.5 or 1 mg tablet twice daily may benefit.

Initial: 0.25 mg twice daily tablet

Dosage for persistent aggression with antisocial behaviour (conduct disorder)

Children (aged 5 to 18 years with weight equal to or more than 50 kg or 110.2 lb)

Recommended: 0.5 mg tablet once daily may be added to the starting dose every other day. In some patients, 1 or 1.5 mg tablet once daily may benefit.

Initial: 0.5 mg once daily tablet

Children (aged 5 to 18 years with weight less than 50 kg or 110.2 lb)

Recommended: 0.25 mg tablet once daily may be added to the starting dose every other day. In some patients, 0.25, 0.5 or 0.75 mg tablet once daily may benefit.

Initial: 0.25 mg once daily tablet

Minimum Age

5 years

Dosage calculation for children

To calculate the dosage for children please use the weight based dose calculator to calculate the appropriate dosage as per the weight of your child.

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Forms

Tablet

Strength: 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, 4 mg and 5 mg

Orally Disintegrating Tablets

Strength: 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, and 4 mg

Solution

Strength: 1 mg/ml

Powder for Suspension, Extended Release Injection

Strength: 12.5 mg, 25 mg, 37.5 mg, and 50 mg

Film-Coated Tablets

Strength: 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, 4 mg, and 6 mg

Coated Tablets

Strength: 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, and 4 mg

Special Instructions

Elderly or weaken patients

The recommended oral dose of Apexidone is 0.5 mg twice daily and it should not be increased more than 0.5 mg twice daily. After one week, the dose may be increased above 1.5 mg twice daily. For Apexidone injection, the recommended dose is 25 mg every two weeks. Along with the first injection, give oral Apexidone and continue for three weeks.

Kidney or liver dysfunction

The recommended dose of Apexidone should be 0.5 mg twice daily orally for the first week, can be increased for the second week to 1 mg twice or 2 mg once daily. If the daily dose of 2 mg is well tolerated, 25 mg injection of Apexidone can be given every 2 weeks. After the first injection, oral dose of Apexidone should be continued for three weeks.

Patients at risk of low blood pressure

The recommended oral dose of Apexidone is 0.5 mg twice daily and it should not be increased more than 0.5 mg twice daily. After one week, the dose may be increased above 1.5 mg twice daily.

Patients having a history of poor tolerability with psychotropic medicines

12.5 mg starting dose of Apexidone should be given to such patients. The efficacy study of 12.5 mg dose has not been established in clinical trials.

Missed Dose

Take the missed dose as soon as you remember. Skip the missed dose if it’s time for the next dose. Do not take a double dose to make up for the dose that you may have missed.

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Overdose

What to do if you overdose on Apexidone?

In case of overdose, oxygen or artificial respiration should be given for breathing problems. Stomach emptying and use of charcoal, a substance that absorbs poisons from the stomach should be done along with stool softeners. Carefully monitor heart and vital signs and also provide supportive care for low blood pressure and failure of blood circulation. Anticholinergic drugs should be given for severe extrapyramidal symptoms. Close monitoring continued until patient recovers.

Symptoms of an overdose of Apexidone

If you use too much of this medicine, it could lead to dangerous levels of the medicine in your body. In such cases, symptoms of an overdose may include:

abnormally fast heart rhythm

drowsiness

extrapyramidal symptoms such as involuntary muscle contractions, motor restlessness, rigidity, slow movement, tremor, irregular body movements

increased heartbeat

low blood potassium level

low blood pressure

low blood sodium level

prolonged heartbeat

seizures

sleepiness

If you think you have overdosed on Apexidone Tablet, call a poison control center immediately. You can look up the poison control center information from the Poison Center Finder at TabletWise.com.

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Precautions while using Apexidone

Before you use Apexidone Tablet, tell your doctor if you are allergic to it or its ingredients. Your doctor may prescribe an alternative medicine and update your medical records to record this information.

Before you use Apexidone, tell your doctor of your medical history including heart problem, drug-induced low level of white blood cells (leukopenia/neutropenia), seizures, drug abuse, diabetes, progressive neurological disorder (Parkinson?s disease), dementia, epilepsy, kidney problems, liver problems, an abnormally high level of the hormone prolactin, family history of blood clots, uncontrolled movement of the mouth, tongue, and face, high temperature, muscle stiffness, sweating, a lowered level of consciousness, prolonged or painful erection, heart problem, drug-induced low level of white blood cells (leukopenia/neutropenia), seizures, drug abuse, diabetes, progressive neurological disorder (Parkinson?s disease), dementia, epilepsy, kidney problems, liver problems, an abnormally high level of the hormone prolactin, family history of blood clots, uncontrolled movement of the mouth, tongue, and face, high temperature, muscle stiffness, sweating, a lowered level of consciousness, prolonged or painful erection, heart attack, heart failure, heart rhythm abnormalities (conduction abnormalities), disease of blood vessels in the brain (cerebrovascular disease), dehydration, decreased blood volume (hypovolemia), or poor tolerability to the medicines that affects the mind. A low dose of Apexidone is used in these patients and caution is advised. Before having any surgery when using Apexidone, tell your doctor and dentist about all the medicinal products you use including prescription and non-prescription medicines, and any herbal supplements.

The use of this medicine may change glucose levels. The diabetic patient should undergo fasting glucose testing at the starting of the treatment and frequently during the therapy. All patients receiving Apexidone should be observed for the symptoms of high blood glucose.

The use of Apexidone Tablet may change white blood cell count. Apexidone may cause a low level of white blood cells. Patients with the history of a low white blood cell count and drug-induced low white blood cell count should have their complete blood count (CBC). Regularly monitor CBC throughout the first few months of the treatment. Discontinuation of the therapy should be considered if there is a sign of a decline in white blood cell count.

The use of this medicine may change the prolactin level. This medicine may increase the level of prolactin hormone. Due to this, a milky discharge from the breast (galactorrhea), an absence of menstruation (amenorrhea), enlarged breasts in men (gynecomastia), and difficulty in erection (impotence) can occur. Long-standing high level of prolactin in the blood (hyperprolactinemia) when associated with abnormally low levels of the sex hormones (hypogonadism) may results in decreased bone density in both male and female.

Avoid the consumption of alcohol with Apexidone Tablet.

Apexidone Tablet should be used in pregnancy only when required. There are increased chances of side-effects in the babies if antipsychotics are used in the third trimester. This may include withdrawal symptoms or extrapyramidal symptoms such as muscle contractions, motor restlessness, rigidity, slowness of movement, tremor and irregular jerky movements. There are some reports of nervousness (agitation), low muscle tone (hypotonia), increased muscle tone (hypertonia), tremor, respiratory distress, sleepiness, or feeding disorder. As a result, the baby should be monitored carefully. Apexidone Tablet is not safe for use in women who are breastfeeding. If you are breastfeeding, discuss with your doctor if you should either discontinue breastfeeding or stop using this medicine while breastfeeding. This medicine may pass into breast milk. Consult with your doctor on the use of Apexidone Tablet, if you are trying to conceive.

Apexidone Tablet can make you feel sleepy. Be careful while driving, using machinery, or doing any other activity that needs you to be alert. The consumption of alcohol with Apexidone Tablet can make you feel more sleepy. Apexidone Tablet may cause seizures in some people. Discuss with your doctor if you perform activities where a loss of consciousness may cause you or others harm.

Apexidone can increase your risk of getting infections/worsen existing infections. Reduce your chances of new infections. Wash your hands often. Avoid people who may have infectious diseases. Prevent injuries, cuts, and bruises. Do not vaccinate without discussing with your doctor. Apexidone may increase the risk of infections such as common cold, flu, inflammation of the lung airways, urinary tract infection, stuffy nose, pneumonia, ear infection, lower respiratory tract infection, inflammation of the pharynx or viral infection, and abscess under the skin (subcutaneous abscess).

Apexidone Tablet may cause an increased risk of side-effects in younger patients. Children using this medicine may see an increased risk of sleepiness, fatigue, headache, increased appetite, vomiting, upper respiratory tract infection, nasal congestion, stomach pain (abdominal pain), dizziness, cough, fever, tremor, diarrhea, and involuntary urination (enuresis).

Apexidone Tablet may increase side-effects in older patients. Elderly patients may see an increased risk of mini-stroke (transient ischaemic attack), stroke (cerebrovascular accident), urinary tract infection, swelling of the legs, lack of energy (lethargy), and cough.

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Apexidone Side-effects

The following side-effects may commonly occur when using Apexidone Tablet. If any of these side-effects worsen or last for a long time, you should consult with your doctor:

abnormal movements of the mouth, eyes, tongue or jaw (dystonia)

anxiety

back pain

blurry vision

chest pain

common cold symptoms

constipation

cough

decreased appetite

depression

diarrhea

dizziness

drowsiness

dry mouth

ear infection (otitis media)

eye infection (conjunctivitis)

fall

fatigue

feeling like flu (influenza-like symptoms)

fever

headache

high blood pressure

increased appetite

increased level of prolactin hormone (hyperprolactinemia)

increased saliva

indigestion (dyspepsia)

infection of the chest (bronchitis)

insomnia

involuntary muscle movements (dyskinesia)

irritability

joint pain (arthralgia)

lack of control of urine (incontinence)

movement disorder due to inner restlessness feeling and an urge to move

muscle pain

muscle spasms

nausea

nose bleeds

parkinsonism

pneumonia

rapid heart rate

rash

shortness of breath

sinus infection

skin redness

sore throat

stomach discomfort (abdominal discomfort)

stomach pain (abdominal pain)

stuffy nose (rhinitis)

swelling of the body, arms or legs

toothache

tremor

upper respiratory tract infection

urinary tract infection

vomiting

weakness

weight gain

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The following side-effects may commonly occur in older patients on the use of Apexidone Tablet. Discuss with your doctor if any of these side-effects last for a long time or are severe:

cough

lethargy

mini stroke (transient ischaemic attack)

stroke (cerebrovascular accident)

swelling of the lower limbs caused by an accumulation of fluid

urinary tract infection

The following side-effects may commonly occur in children when using Apexidone Tablet. Discuss with your doctor if any of these side-effects last for a long time or are severe:

abnormal vision

anxiety

confusion

constipation

cough

diarrhea

dizziness

drowsiness

dry mouth

fatigue

fever

headache

increased appetite

increased heartbeat

increased saliva

increased weight

indigestion (dyspepsia)

involuntary muscle contractions (dystonia)

involuntary muscle movements (dyskinesia)

involuntary urination (enuresis)

leakage of milk from the breasts (lactation nonpuerperal)

loss of appetite resulting in malnutrition and low body weight (anorexia)

movement disorder due to inner restlessness feeling and an urge to move

nasal congestion

nausea

progressive neurological disorder (Parkinson disorder)

rash

shortness of breath (dyspnea)

stomach pain (abdominal pain)

stuffy nose (rhinitis)

tremor

unconscious behavior (automatism)

upper respiratory tract infection

vomiting

Rarely, the use of Apexidone Tablet may cause the following side-effects:

a state of near-unconsciousness

a sudden feeling of cold (rigors)

abnormal coordination

abnormal crying

abnormal gait

absence of menstrual period (amenorrhoea)

accumulation of fluid

acne

an adverse drug reaction of the skin (drug eruption)

an eye syndrome in which iris slips towards the area of an incision during cataract surgery (intraoperative floppy iris syndrome)

antiemetic effect

back pain

balance disorder

breast discomfort

breast pain

chapped lips (cheilitis)

chest discomfort

chest pain

chills

collection of hardened feces in the rectum (faecaloma)

dandruff

dangerously excessive intake of water (polydipsia)

decreased libido

decreased response of the skin to touch and pain (hypoesthesia)

decreased sexual drive (sexual dysfunction)

decreased taste sensitivity

decreased weight

difficult urination

difficulty in erection (erectile dysfunction)

difficulty swallowing (dysphagia)

discharge from the breasts

disruption of body temperature regulation

disturbance in attention

disturbed focus

drug withdrawal syndrome in newborn babies

dry eye (xerophthalmia)

dry skin

ear pain

eczema

ejaculation disorder

excessive passing of gas

extraordinary daytime urinary frequency (pollakiuria)

eye movement disorder

eye rolling

eyelid margin crusting

fast, shallow breathing (hyperventilation)

feeling abnormal

feeling of discomfort

flushing

frequent passing of urine (micturition frequency)

fungal infection of the nails (onychomycosis)

glucose present in urine

hair loss

hives

inability to control bowel movements (faecal incontinence)

inability to pass urine

inability to reach orgasm (anorgasmia)

inappropriate antidiuretic hormone secretion

increase in a type of white blood cells

increased and decreased appetite

increased blood creatine phosphokinase enzyme

increased body temperature

increased heartbeat

increased tears

inflammation of the tonsils (tonsillitis)

infrequent menstrual periods (oligomenorrhoea)

involuntary laughing and crying

irregular or absent periods (anovulation)

joint stiffness

joint swelling

lack of emotion

lack of energy

lack of interest (apathy)

lack of muscle coordination

leg cramps

leg pain

low body weight (anorexia)

menstrual disorders

muscle or skeletal pain

muscle rigidity

muscle spasms

muscle weakness

nasal congestion

neck pain

nervousness

nightmare

no emotional expression

oversensitivity of the eyes to light

pain in joints (arthralgia)

pain in pharynx and larynx

painful erection (priapism)

palpitations

parkinsonian gait

parkinsonian rest tremor

photophobia

postural dizziness

procedural pain

prolonged and irregular heartbeat

psychomotor hyperactivity

puberty occurring at an unusually early age (precocious puberty)

red, itchy rash and white scales (seborrhea)

redness of the eye (ocular hyperaemia)

reduced sense of touch (hypoaesthesia)

ringing in the ears

severe itching

shaking of the head (head titubation)

skin discolouration

skin disorder

skin lesion

sleep walking

sleep-related eating disorder

speech disorder

stomach and intestinal infection

sugar in the urine

swelling of body tissues due to fluid accumulation

swelling of the face

swollen breast tissue in men

thickening of the skin (hyperkeratosis)

thirst

unconscious behavior (automatism)

unresponsive stimuli

urinary incontinence

vaginal discharge (leukorrhea)

vertigo

weight gain

The following severe side-effects may also occur when using Apexidone Tablet:

twitching or jerking movements of the body (tardive dyskinesia)

Symptoms: involuntary movement of the tongue, involuntary movement of the mouth involuntary movement of the face

If this happens, contact the doctor immediately. The withdrawal of the medicine may be needed.

blood clots in the veins

Symptoms: swelling on the affected area, pain on the affected area redness on the affected area

If this happens, seek medical help immediately.

painful erection (priapism)

Symptoms: painful or prolonged erection

If such side-effect occurs, contact your doctor immediately.

increased blood sugar level (diabetes mellitus) (production of excessive acids in the blood (diabetic ketoacidosis), coma or can be possibly fatal)

Symptoms: excessive thirst, increased urination, increased appetite weakness

If these symptoms appear, perform the test for fasting blood glucose level. The discontinuation of medicine may be needed.

decreased white blood cells

Symptoms: low white blood cell count, fever infection

Monitor the patients with a history of low white blood cell count during the therapy for such symptoms. Stop using Apexidone if a decrease in cell count is seen.

stroke (when used elderly patients with dementia related mental disorder (dementia-related psychosis)) (can be possibly fatal)

Symptoms: mental state changes, numbness of the face, numbness of the arms, numbness of the legs slurred speech

Do not use Apexidone in elderly patients with dementia-related psychosis.

a rare life-threatening reaction to the medicines used to treat mental disorders (neuroleptic malignant syndrome) (can be possibly fatal)

Symptoms: muscle stiffness, fever, reduced level of consciousness, sweating, altered mental status, irregular pulse, irregular blood pressure, increased or irregular heartbeat, increased creatine phosphokinase level, muscle breakdown acute kidney failure

If this happens, stop using antipsychotic drugs immediately. The treatment should be given according to the symptoms and the patient should be monitored carefully.

severe allergic reaction

Symptoms: fever, swollen mouth, swollen face, swollen lips, swollen tongue, shortness of breath, itching, skin rash low blood pressure

If this happens, ask your doctor immediately.

respiratory disorders

Symptoms: stuffy nose (rhinitis) inflammation of the pharynx (pharyngitis)

progressive neurological disorder (Parkinson disorder)

Symptoms: slow movement, sensation of stiffness, tightness of the muscles, sensation of freezing movement, slow shuffling walk, tremor while at rest, increased saliva, drooling, loss of expression, muscular rigidity, slowness of movement (bradykinesia), loss of muscle movement (akinesia), an inability to flex the neck forward (nuchal rigidity), parkinsonian gait blink in response to the several taps on forehead

Your doctor has prescribed Apexidone Tablet because they judge that the benefit is greater than the risk posed by side-effects. Many people using this medicine do not have serious side-effects. This page does not list all possible side-effects of Apexidone Tablet.

If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

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Warnings

Difficulty swallowing (dysphagia)

Patients with aspiration pneumonia and patients who have started antipsychotic therapy are at an increased risk. Such patients may suffer from regurgitation of food, difficulty in swallowing, and a spasm type pain (esophageal dysmotility) and sucking food into the airway (aspiration). Patients at risk for lung infection due to the inhaled food, saliva, or stomach acid into the lungs (aspiration pneumonia) should use Apexidone and other antipsychotic medicines with caution.

Seizures

Patients with schizophrenia and seizures are at an increased risk when using this medicine. These patients may suffer from seizures. It is advised to use this medicine with caution in the patients with a history of seizures.

Problems with muscle function

Patients using Apexidone are at an increased risk. These patients may develop a problem with thinking, judgment, or movement of muscles. In these patients, precaution is advised while operating heavy machinery.

Low white blood cell count

Patients with a history of a drug-induced low level of white blood cells and existing low white blood cell count are at an increased risk when using this medicine. These patients may suffer from low white blood cell count (leukopenia, neutropenia, and deficiency of granulocytes in the blood). It is advised to monitor the patient for fever and other signs or symptoms of infection. If a severely low level of white blood cells occurs then discontinue the use of this medicine.

Postural low blood pressure

Patients with a decrease in blood pressure, while standing up from sitting or lying down using Apexidone, are at an increased risk. These patients may suffer from low blood pressure, dizziness, rapid heartbeat and fainting. In these patients, a low dose of Apexidone is recommended to reduce the risk of low blood pressure. Also, precaution is advised when using Apexidone in patients with heart diseases such as heart attack, heart failure, heart rhythm abnormalities, a disease of blood vessels in the brain (cerebrovascular disease), dehydration and decreased blood volume. The monitoring of vital signs should also be considered.

High prolactin level (hyperprolactinemia)

Patients using Apexidone and patients with existing high level of blood prolactin (hyperprolactinaemia) are at an increased risk. In these patients, prolactin levels may be increased in the blood. Due to this, a milky discharge from the breast (galactorrhea), an absence of menstruation (amenorrhea), enlarged breasts in men (gynecomastia), and difficulty in erection (impotence) can occur. Long-standing high level of prolactin in blood when associated with abnormally low levels of the sex hormones (hypogonadism) may results in decreased bone density in both male and female. When using this medicine, caution is advised especially in patients with existing high level of blood prolactin or patients with chances of prolactin-dependent tumors.

High blood glucose level (hyperglycemia)

Patients treated with atypical antipsychotics are at an increased risk. These patients may suffer from a high buildup of acids in the blood (ketoacidosis), coma, or fatality. If this happens, discontinue using this medicine. Some patients may need anti-diabetic treatment.

Repetitive involuntary body movements (tardive dyskinesia)

Patients who have started antipsychotic therapy are at an increased risk. These patients may develop irreversible or involuntary muscle movements. If this happens, discontinuation of Apexidone is advised.

Syndrome caused by antipsychotic drugs (neuroleptic malignant syndrome)

Patients using antipsychotic drugs are at an increased risk. These patients may develop signs including muscle rigidity, fever, evidence of autonomic instability, altered mental status, the presence of myoglobin in the urine, increased level of enzyme creatinine phosphokinase and acute kidney failure. If this happens, stop using antipsychotic drugs immediately. The treatment should be given according to the symptoms and the patient should be monitored carefully.

Dementia-related psychosis

The older adults with dementia-related psychosis are at an increased risk when using this medicine. These patients may suffer from stroke, mini-stroke and mortality. In such patients, Apexidone should not be used.

Prolonged erection (priapism)

A prolonged erection (priapism) may occur with the use of this medicine. The severe priapism is corrected by surgical treatment.

Changes in body temperature

Patients treated with antipsychotic drugs are at an increased risk. These patients may experience an increase or decrease in body temperature. The patients who exposed to temperature extremes should use Apexidone and other antipsychotic medicines with caution.

Antiemetic effect

This medicine may cause an antiemetic effect. It may hide signs and symptoms of overdosage with several drugs or diseases such as brain and liver damage (Reye?s syndrome), intestinal obstruction, and brain tumor.

Possiblity of suicide

Patients with periods of abnormally elevated mood (bipolar mania) and severe mental disorder (schizophrenia) including adults and children are at an increased risk when using this medicine. There should be the chances of suicidal attempt in such patients. In such cases, the smallest effective dose is recommended to reduce the chances of overdose.

Brain disorders

Patients with brain disorders such as Parkinson?s disease or dementia with lewy bodies are at an increased risk when using this medicine. These patients may suffer from confusion, altered level of consciousness, postural instability with frequent falls, symptoms related to involuntary actions (extrapyramidal symptoms), and a syndrome caused by antipsychotic drugs (neuroleptic malignant syndrome). In these patients, this medicine should be used with caution.

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Interactions with Apexidone

When two or more medicines are taken together, it can change how the medicines work and increase the risk of side-effects. In medical terms, this is called as a Drug Interaction.

Apexidone Tablet may interact with drugs acting on central nervous system and alcohol. The use of Apexidone with drugs acting on central nervous system and alcohol increases the risk of sleepiness or sedation. When Apexidone is used with other drugs that act on central nervous systems such as opiates, antihistamines and benzodiazepines and alcohol, caution should be used.

There may be an interaction of Apexidone with drugs with blood pressure lowering effects, which are used to treat high blood pressure. If Apexidone is used with blood pressure lowering drugs, it may enhance the blood pressure lowering effect of that drugs.

Apexidone Tablet interacts with levodopa and dopamine agonists, which are used to treat a Parkinson’s disease. When Apexidone is used with levodopa and dopamine agonists, Apexidone blocks the effect of these drugs. If the use of Apexidone with levodopa and dopamine agonists is necessary, the lowest effective dose of each drug should be used to treat end-stage Parkinson’s disease.

Special instructions need to be followed while taking this medicine along with cimetidine and ranitidine, which are used to treat stomach ulcers. If the Apexidone is used with cimetidine and ranitidine, the amount of Apexidone in the blood increases.

Your doctor’s guidelines may need to be followed while taking this medicine along with clozapine, which is used to treat severe mental illness (schizophrenia). When Apexidone and clozapine are used together, the clearance of Apexidone is reduced.

Apexidone Tablet may interact with valproate, which is used to treat epileptic disease. If the Apexidone is used with valproate, the amount of valproate in the blood is mildly increased.

There may be an interaction of Apexidone with inhibitors of CYP2D6, CYP3A4, P-gp and other CYP isoenzymes. When Apexidone and CYP2D6 inhibitors (for example, paroxetine, quinidine and fluoxetine) are used together, the amount of Apexidone increases in the blood and lowers the level of its metabolite. When Apexidone and CYP3A4, P-gp inhibitors (for example, itraconazole) are used together, the amount of active fraction of Apexidone increases in the blood. When the use of Apexidone with CYP2D6 inhibitors, CYP3A4, P-gp inhibitors is initiated or stopped, dosage adjustment may be required.

Apexidone Tablet interacts with fluoxetine and paroxetine, which are used to treat depression. If the Apexidone is used with fluoxetine or paroxetine, the amount of Apexidone is increased in the blood. When the use of Apexidone with fluoxetine and paroxetine is initiated or stopped, the dosage of #NAME should be re-evaluated.

Special instructions need to be followed while taking this medicine along with carbamazepine and other enzyme inducers, which is used to control and prevent seizures. When Apexidone is used with carbamazepine and other enzyme inducers such as phenytoin and phenobarbital, the amount of metabolite of Apexidone decreases in the blood.

Your doctor’s guidelines may need to be followed while taking this medicine along with drugs that prolong the heartbeat (QT interval). When Apexidone is used with drugs that prolong the heartbeat such as antiarrhythmics, tricyclic antidepressants, tetracyclic antidepressants, antihistamines, other antipsychotics, antimalarials and with medicines causing electrolyte imbalance, bradycardia, or those which prevent the breakdown of Apexidone by liver, caution should be taken.

Apexidone Tablet may interact with furosemide, which is used to treat fluid accumulation in heart, kidney or liver diseases. When Apexidone is used with furosemide, it can cause loss of water from the body which can be possibly fatal in the elderly patients with dementia. The use of Apexidone with furosemide should be avoided in the elderly patients with dementia.

There may be an interaction of Apexidone with paliperidone, which is used to treat mental or mood disorders. The use of Apexidone with paliperidone may lead to an increased amount of total active metabolite in the body. The use of Apexidone with paliperidone is not recommended.

Apexidone Tablet interacts with rifampicin, which is used to treat bacterial infection. When Apexidone is used with rifampicin, the amount of active metabolite of Apexidone in the blood decreases.

Special instructions need to be followed while taking this medicine along with ketoconazole, which is used to treat fungal infection. When Apexidone is used with ketoconazole, the amount of Apexidone in the blood increases and the amount of metabolite of Apexidone decreases.

Your doctor’s guidelines may need to be followed while taking this medicine along with phenothiazines, which are used to treat mental dis