Marcus
Generic Name
Marcuserine Hydrochloride
Manufacturer
MediCorp Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| marcus 25 mg tablet | ৳ 12.00 | ৳ 120.00 |
Description
Overview of the medicine
Marcus 25 mg Tablet contains Marcuserine Hydrochloride, a selective serotonin reuptake inhibitor (SSRI) used to treat major depressive disorder, generalized anxiety disorder, and panic disorder.
Uses & Indications
Dosage
Adults
Initial dose: 25 mg once daily. May be increased to 50 mg after 1 week. Max dose: 100 mg daily.
Elderly
Initial dose: 25 mg once daily. Dose adjustments should be made cautiously based on tolerability and response.
Renal_impairment
No dose adjustment is generally required for mild to moderate renal impairment. Use with caution in severe impairment.
How to Take
Take orally once daily, with or without food, preferably at the same time each day.
Mechanism of Action
Marcuserine selectively inhibits the reuptake of serotonin (5-HT) into presynaptic neurons in the central nervous system, thereby increasing the concentration of serotonin in the synaptic cleft. This leads to enhanced serotonergic neurotransmission, which is believed to be responsible for its antidepressant and anxiolytic effects.
Pharmacokinetics
Onset
Initial antidepressant effects may be seen within 1-2 weeks, full therapeutic effects typically within 4-6 weeks.
Excretion
Excreted primarily via urine (60%) and feces (40%) as metabolites.
Half life
Approximately 20-30 hours, with active metabolites having a slightly longer half-life.
Absorption
Well absorbed orally, peak plasma concentrations reached within 4-8 hours. Bioavailability is approximately 80%.
Metabolism
Extensively metabolized in the liver primarily by CYP2D6 and CYP3A4 enzymes to active and inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to Marcuserine or any excipients.
- Concurrent use with Monoamine Oxidase Inhibitors (MAOIs) or within 14 days of discontinuing an MAOI.
Drug Interactions
MAOIs
Concomitant use can lead to serious, sometimes fatal, reactions including Serotonin Syndrome.
NSAIDs
Increased risk of gastrointestinal bleeding.
Tramadol
Increased risk of Serotonin Syndrome.
Warfarin
May increase anticoagulant effect, requiring close INR monitoring.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include drowsiness, nausea, vomiting, tachycardia, tremor, and agitation. Management is symptomatic and supportive, including maintaining an open airway, cardiac monitoring, and administration of activated charcoal.
Pregnancy & Lactation
Pregnancy Category C. Use only if potential benefit justifies the potential risk to the fetus. Marcuserine is excreted in breast milk; advise caution during lactation.
Side Effects
Contraindications
- Hypersensitivity to Marcuserine or any excipients.
- Concurrent use with Monoamine Oxidase Inhibitors (MAOIs) or within 14 days of discontinuing an MAOI.
Drug Interactions
MAOIs
Concomitant use can lead to serious, sometimes fatal, reactions including Serotonin Syndrome.
NSAIDs
Increased risk of gastrointestinal bleeding.
Tramadol
Increased risk of Serotonin Syndrome.
Warfarin
May increase anticoagulant effect, requiring close INR monitoring.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include drowsiness, nausea, vomiting, tachycardia, tremor, and agitation. Management is symptomatic and supportive, including maintaining an open airway, cardiac monitoring, and administration of activated charcoal.
Pregnancy & Lactation
Pregnancy Category C. Use only if potential benefit justifies the potential risk to the fetus. Marcuserine is excreted in breast milk; advise caution during lactation.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months from the date of manufacture.
Availability
Available in pharmacies nationwide
Approval Status
Approved by Regulatory Authority
Patent Status
Patented by manufacturer
Clinical Trials
Extensive clinical trials have demonstrated the efficacy and safety of Marcuserine in the treatment of major depressive disorder and anxiety disorders.
Lab Monitoring
- Monitor liver function tests periodically, especially in patients with hepatic impairment.
- Monitor serum sodium levels in elderly or volume-depleted patients.
Doctor Notes
- Educate patients on the delayed onset of action and the importance of adherence.
- Monitor for signs of suicidality, especially at the initiation of therapy or during dose changes.
- Assess for potential drug interactions, particularly with other serotonergic agents.
Patient Guidelines
- Do not stop taking Marcus abruptly; doses should be tapered gradually under medical supervision.
- Report any worsening depression or suicidal thoughts immediately to your doctor.
- Avoid driving or operating heavy machinery until you know how this medicine affects you.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose.
Driving Precautions
Marcus may cause dizziness, drowsiness, or blurred vision. Patients should be cautioned about operating hazardous machinery, including automobiles, until they are reasonably certain that Marcuserine therapy does not adversely affect their ability to engage in such activities.
Lifestyle Advice
- Maintain a regular sleep schedule.
- Engage in regular physical activity.
- Practice stress-reduction techniques.
- Avoid excessive caffeine and alcohol.
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