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CARDIOVASCULAR SYSTEM › ANTIHYPERTENSIVES › ANTIADRENERGIC AGENTS, CENTRALLY ACTING › Rauwolfia alkaloids
rescinnamine
C02AA01
Forms & Strengths
- Oral tablets: 0.25 mg, 0.5 mg
Adult Dosing
- Hypertension: Initially 0.5 mg daily in single or divided doses, adjusted based on patient response
- Maintenance: 0.25 mg to 0.5 mg daily
Pediatric Dosing
- Safety and efficacy not established in pediatric patients
Indications
- Management of essential hypertension (typically as adjunctive therapy)
Mechanism of Action
- Rauwolfia alkaloid acting as a peripheral sympatholytic
- Depletes catecholamines and serotonin in peripheral nerve terminals and the central nervous system
- Results in decreased heart rate, cardiac output, and peripheral vascular resistance
Contraindications
- Known hypersensitivity to rescinnamine or other Rauwolfia alkaloids
- Active peptic ulcer disease
- Ulcerative colitis
- Depression (history of or active, particularly with suicidal tendencies)
- Patients receiving monoamine oxidase (MAO) inhibitors
Adverse Reactions
- Central nervous system: Depression, sedation, drowsiness, fatigue, nightmares
- Gastrointestinal: Increased gastric acid secretion, diarrhea, nausea, vomiting, anorexia
- Cardiovascular: Bradycardia, orthostatic hypotension, syncope
- Respiratory: Nasal congestion, dyspnea
- Endocrine/Metabolic: Fluid retention, weight gain
Drug Interactions
- MAO inhibitors: May cause severe CNS excitation and hypertension
- Antihypertensives and diuretics: Potentiates blood pressure-lowering effects
- Digitalis glycosides or quinidine: May precipitate cardiac arrhythmias
- Levodopa: Decreased effectiveness of levodopa
- Central nervous system depressants (alcohol, barbiturates): Enhanced sedative effects
Curated Content: Needs Vetting Before Put to Clinical Use