ClinCalc Pro
Menu
Calculators Drugs Pathways AI Dx Donate Get the App
NRI (Selective Noradrenaline Reuptake Inhibitor) Pregnancy: Avoid — insufficient data. Use sertraline in preference.

Reboxetine

Brand names: Edronax

Adult dose

Dose: Depression: 4mg BD (8mg daily) initially; increase after 3–4 weeks to 10mg daily (5mg BD) if needed; maximum 12mg daily.
Route: Oral
Frequency: Twice daily
Max: 12mg daily
Selective noradrenaline reuptake inhibitor — no serotonergic activity. May be useful when serotonergic side effects (sexual dysfunction, nausea) are problematic. Evidence base weaker than SSRIs — meta-analyses suggest modest efficacy; consider as add-on or alternative when other antidepressants have failed. Reduces social withdrawal and motivational deficits.

Paediatric dose

Route: Oral
Frequency: Twice daily
Max: Not applicable
Not licensed under 18 years. Seek specialist child and adolescent psychiatry opinion.

Dose adjustments

Renal

eGFR <30: reduce to 2mg BD initially; maximum 6mg daily.

Hepatic

Hepatic impairment: reduce to 2mg BD initially; maximum 6mg daily.

Clinical pearls

  • Cochrane review (2010): reboxetine less effective and worse tolerated than SSRIs for depression — should not be first-line but may have a place in specific patients (sexual dysfunction from SSRIs, motivational deficits, social withdrawal)
  • Urinary hesitancy: noradrenergic effect on bladder neck — caution in men with BPH; may worsen urinary flow
  • Activating profile: take last dose in early afternoon to avoid insomnia
  • No sexual dysfunction (no serotonergic activity) — advantage in patients where sexual side effects are unacceptable

Contraindications

  • MAOIs within 14 days
  • Acute MI or unstable angina
  • Hypersensitivity to reboxetine

Side effects

  • Dry mouth (common — noradrenergic)
  • Constipation
  • Insomnia (activating)
  • Urinary hesitancy / retention (noradrenergic — alpha-1 effect)
  • Sweating
  • Tachycardia
  • Hyponatraemia (SIADH — less common than SSRIs)
  • Hypotension

Interactions

  • MAOIs — contraindicated (14-day washout)
  • Potassium-lowering drugs — reboxetine may cause hypokalaemia; monitor electrolytes
  • CYP3A4 inhibitors (azoles, macrolides) — increase reboxetine levels

Monitoring

  • Blood pressure
  • Urinary symptoms (retention)
  • Electrolytes (potassium)
  • Mood response at 4–6 weeks

Reference: BNFc; BNF 90; Cochrane Review (Reboxetine for Depression 2010). Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.

Calculators
Pathways