- Severe hepatic Impairment
- If doses are missed >72 hours, retitrate up to prior dose (risk of Orthostatic Hypotension)
- Start: 1 mg orally twice daily
- May increase by up to 2 mg orally twice daily slowly (risk of Orthostatic Hypotension with rapid increase)
- Target therapeutic dose: 6 to 12 mg orally twice daily
- Maximum: 24 mg/day
- Atypical Antipsychotic Medication
- Dopamine D2 Antagonist
- Serotonin 5HT2 Antagonist
- Low risk of Extrapyramidal Side Effects and Akathisia
- Metabolized by CYP3A4, CYP2D6
- Decrease dose 50% if taking strong CYP3A4 or CYP2D6 Inhibitors
- Avoid other medication causes of Drug-Induced QTc Prolongation
- (2016) Med Lett Drugs Ther 58(1510): 160-5
- Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 44-5
- Hamilton (2020) Tarascon Pocket Pharmacopoeia