Disorders of Menstruation

Citalopram brand name

Celexa

Citalopram class:

SSRI

Citalopram dosing for PMDD:

20mg PO QD or 30mg PO QD during luteal phase

Citalopram dosing for menopause:

10mg PO QD; max 20mg PO QD

Citalopram ADE:

QT prolongation, serotonin syndrome, hyponatremia, suicidal thoughts and behaviors, sexual dysfunction

Citalopram monitoring:

potassium, magnesium, bone mineral density, QT interval, bradycardia, weight gain

Citalopram black box warning:

suicidal thoughts and behaviors

Escitalopram brand name:

Lexapro

Escitalopram class:

SSRI

Escitalopram dosing for PMDD:

5mg PO on day 1, 10mg PO on day 2, 20mgPO QD after; start on day of ovulation and continue until 1st day of menstruation

Adjustments for escitalopram:

CrCl <20 mL/min: 5mg PO QD, titrate up

Escitalopram ADE:

QT prolongation, serotonin syndrome, hyponatremia, suicidal thinking and behaviors, sexual dysfunction

Escitalopram monitoring:

potassium, magnesium, bone mineral density, QT interval, bradycardia, weight gain

Escitalopram black box warning:

suicidal thoughts and behaviors

Sertraline brand name:

Zoloft

Sertraline class:

SSRI

Sertraline dosing for PMDD:

50mg PO QD in the morning or evening; or (luteal phase dosing) 50mg PO QD x3 days, 100mg PO QD for the rest of the luteal phase

Sertraline ADE:

hypersensitivity, serotonin syndrome, suicidal thoughts and behaviors, hyponatremia, sexual dysfunction

Sertraline monitoring:

sodium, weight

Sertraline black box warning:

suicidal thoughts and behaviors

Venlafaxine brand name:

Effexor XR

Venlafaxine class:

SNRI

Venlafaxine dosing for PMDD:

37.5mg PO QD x1 month, increase to 75mg PO QD over the 1st month; max dose 150mg PO QD

Venlafaxine adjustments:

CrCl <30 mL/min: 37.5mg PO QD; max 75mg PO QD

Venlafaxine ADE:

hypersensitivity, serotonin syndrome, suicidal thoughts and behaviors, hyponatremia, sexual dysfunction, increased BP

Venlafaxine monitoring:

BP, lipids, mood, electrolytes, weight

Venlafaxine black box warning:

suicidal thoughts and behaviors

Anastrozole brand name:

Arimidex

Anastrozole class:

aromatase inhibitor

Anastrozole dosing for ovulation induction:

1mg PO QD or 10mg PO QD for cycle days 3-7 or 5-9

Anastrozole adjustments:

use not recommended if severe hepatic impairment

Anastrozole ADE:

hot flushes, n/v, leg cramps, decreased bone mineral density, MI

Anastrozole monitoring:

BMD, lipids (TC, LDL)

Letrozole brand name:

Femara

Letrozole class:

aromatase inhibitor

Letrozole dosing for ovulation induction:

2.5mg PO QD x5 days on cycle days 3-7 or 5-9; can increase to 5mg or 7.5mg; max 7.5mg PO QD

Letrozole ADE:

decreased bone mineral density, MI, musculoskeletal effects

Letrozole monitoring:

hepatic fxn tests, BMD