RAUWOLFIA ALKALOIDS

Brand & Generic Names

DESERPIDINE	RAUWOLFIA SERPENTINA
Harmonyl	Reserfia
Novoreserpine	RESERPINE
Raudixin	Serpalan
Rauval	Serpasil
Rauverid	Wolfina

Basic Information

• Habit forming? No
• Prescription needed? Yes
• Available as generic? Yes
• Drug class: Antihypertensive, tranquilizer (rauwolfia alkaloid)

Uses

• Treatment for high blood pressure.
• Tranquilizer for mental and emotional disturbances.

Dosage & Usage Information

How to take:
Tablet or timed-release capsule--Swallow with liquid or food to lessen stomach irritation. If you can't swallow whole, crumble tablet or open capsule and take with liquid or food.

When to take:
At the same times each day.

If you forget a dose:
Take as soon as you remember up to 2 hours late. If more than 2 hours, wait for next scheduled dose (don't double this dose).

What drug does:
Interferes with nerve impulses and relaxes blood vessel muscles, reducing blood pressure.
Suppresses brain centers that control emotions.

Time lapse before drug works:
3 weeks continual use required to determine effectiveness.

Don't take with:
Any other medicine without consulting your doctor or pharmacist.

Overdose

SYMPTOMS:
Drowsiness; slow, weak pulse; slow, shallow breathing; diarrhea; coma; flush; low body temperature; pinpoint pupils.

WHAT TO DO:

• Dial 911 (emergency) or O (operator) for an ambulance or medical help. Then give first aid immediately.
• See EMERGENCY Information.

Possible Adverse Reactions or Side Effects

Life-threatening:

In case of overdose, see Overdose section.

Common:

• Depression, dizziness.
• Headache, faintness, drowsiness, lethargy, red eyes, stuffy nose, impotence, diminished sex drive, diarrhea, dry mouth.

Infrequent:

• Black stool; bloody vomit; chest pain; shortness of breath; irregular or slow heartbeat; stiffness in muscles, bones, joints.
• Trembling hands, foot and leg swelling.

Rare:

• Rash or itchy skin, sore throat, fever, abdominal pain, nausea, vomiting, unusual bleeding or bruising, jaundice.
• Painful urination, nightmares.

Warnings & Precautions

Don't take if:

• You are allergic to any rauwolfia alkaloid.
• You are depressed.
• You have active peptic ulcer.
• You have ulcerative colitis.

Before you start, consult your doctor:

• If you have been depressed.
• If you have had peptic ulcer, ulcerative colitis or gallstones.
• If you have epilepsy.
• If you will have surgery within 2 months, including dental surgery, requiring general or spinal anesthesia.

Over age 60:
Adverse reactions and side effects may be more frequent and severe than in younger persons.

Pregnancy:
Studies inconclusive on harm to unborn child. Animal studies show fetal abnormalities. Decide with your doctor whether drug benefits justify risk to unborn child.

Breast-feeding:
Drug passes into milk. Avoid drug or discontinue nursing until you finish medicine. Consult doctor for advice on maintaining milk supply.

Infants & children:
Not recommended.

Prolonged use:

• Causes cancer in laboratory animals. Consult your doctor if you have family or personal history of cancer.
• Talk to your doctor about the need for follow-up medical examinations or laboratory studies.

Skin & sunlight:
No problems expected.

Driving, piloting or hazardous work:
Avoid if you feel drowsy, dizzy or faint. Otherwise, no problems expected.

Discontinuing:
Don't discontinue without consulting doctor. Dose may require gradual reduction if you have taken drug for a long time. Doses of other drugs may also require adjustment.

Others:
Consult your doctor if you do isometric exercises. These raise blood pressure. Drug may intensify blood pressure rise.

Possible Interaction with Other Drugs

GENERIC NAME	COMBINED EFFECT
------------------------	-----------------------
Anticoagulants*,	Unpredictable increased or
oral	decreased effect of anticoagulant.
Anticonvulsants*	Serious change in seizure pattern.
Antidepressants*	Increased antidepressant effect.
Antihistamines*	Increased antihistamine effect.
Antihypertensives*,	Increased effect of rauwolfia.
Aspirin	Decreased aspirin effect.
Beta-adrenergic	Increased effect of rauwolfia
blockers*	alkaloids. Excessive
	sedation.
Carteolol	Increased antihypertensive effect.
Clozapine	Toxic effect on the central nervous
	system.
Digitalis	Possible irregular heartbeat.
Dronabinol	Increased effects of both drugs.
	Avoid.
Ethinamate	Dangerous increased effects of
	ethinamate. Avoid combining.
Fluoxetine	Increased depressant effects of
	both drugs.
Guanfacine	May increase depressant effects of
	either medicine.
Leucovorin	High alcohol content of leucovorin
	may cause adverse effects.
Levodopa	Decreased levodopa effect.
Lisinopril	Increased antihypertensive effect.
	Dosage of each may require
	adjustment.
Loxapine	May increase toxic effects of both
	drugs.
MAO inhibitors*	Severe depression.
Methyprylon	May increase sedative effect to
	dangerous level. Avoid.
Mind-altering drugs*	Excessive sedation.
Nabilone	Greater depression of central
	nervous system.
Nicardipine	Blood pressure drop. Dosages may
	require adjustment.
Nimodipine	Dangerous blood pressure drop.
Pergolide	Decreased pergolide effect.
Sertraline	Increased depressive effects
	of both drugs.
Sotalol	Increased antihypertensive effect.
Terazosin	Decreases effectiveness of
	terazosin.

Possible Interaction with Other Substances

INTERACTS WITH	COMBINED EFFECT
---------------	---------------
Alcohol:	Increased intoxication. Use with
	extreme caution.
Carbonated drinks.	Decreased rauwolfia alkaloid
	effect.
Cocaine:	Increased risk of heart block and
	high blood pressure.
Spicy foods.	Possible digestive upset.
Marijuana:	Occasional use--Mild drowsiness.
	Daily use--Moderate drowsiness, low
	blood pressure, depression.
Tobacco:	No problems expected.