Urelle
Urelle
Generic Name
Urelle
Mechanism
Urelle is a highly selective serotonin‑reuptake inhibitor (SSRI). It binds with high affinity to the serotonin transporter (SERT), blocking re‑uptake of serotonin from the synaptic cleft and thereby increasing extracellular serotonin levels in key brain regions involved in mood regulation and anxiety.
• Primary target: SERT
• Result: Augmented serotonergic neurotransmission → antidepressant and anxiolytic effects
Pharmacokinetics
| Parameter | Value | Notes |
| Oral bioavailability | ~80 % | Dose‑dependent plateau at 10 mg |
| Peak concentration (Tmax) | 4–6 h | Rapid absorption |
| Half‑life | 12–15 h | Supports once‑daily dosing |
| Metabolism | Primarily CYP2D6; minor CYP3A4 contribution | Poor CYP2D6 metabolizers may need dose adjustment |
| Excretion | 60 % unchanged urine; 30 % fecal | Limited renal clearance in mild impairment |
Indications
- Major Depressive Disorder (MDD)
- Generalized Anxiety Disorder (GAD)
- Social Anxiety Disorder
- Obsessive‑Compulsive Disorder (OCD)
Contraindications
- Hypersensitivity to Urelle or excipients
- Concurrent use of monoamine‑oxidase inhibitors (MAOIs) within 14 days
- Severe hepatic impairment (Child‑Pugh C)
- Pregnancy (Category C); use only if benefit > risk
- Known risk factors for serotonin syndrome (e.g., other serotonergic drugs)
- Patients <25 years: monitor for suicidal ideation
Dosing
- Adults: 10–20 mg PO once daily.
- Initiate at 10 mg; if tolerated, titrate to 20 mg after 1 week.
- Elderly: Start 10 mg; increase cautiously.
- Renal impairment: No dose change for CrCl > 30 mL/min.
- Alcohol: Avoid; increases CNS depression and hyponatremia risk.
Adverse Effects
- Common: Nausea, insomnia, dry mouth, sexual dysfunction, dizziness
- Serious:
- Hyponatremia (especially in elderly)
- Serotonin syndrome (hyperthermia, clonus)
- QT prolongation (rare)
- Agranulocytosis (extremely rare)
Monitoring
- Baseline & periodic: CBC, LFTs, electrolytes (Na⁺, K⁺, Cl⁻)
- ECG: If QT prolongation suspected or baseline abnormality
- Psychological: Mood and suicidality assessment at baseline, week 2, week 4, then monthly for first 6 months
Clinical Pearls
- Titration strategy: Low‑dose start (10 mg) minimizes nausea and allows early detection of serotonin syndrome.
- Drug interactions: Avoid MAOIs, triptans, other SSRIs/SNRIs; use with caution alongside NSAIDs or antiplatelets.
- Alcohol: Strongly contraindicated—can potentiate CNS depression and hyponatremia.
- Pregnancy: Category C; many clinicians consider Urelle acceptable in the second/third trimester, but first‑trimester exposure is best avoided if possible.
- Discontinuation: Taper over 2–4 weeks to reduce withdrawal (dizziness, flu‑like symptoms, GI upset).
*Key pharmacology terms: SSRI, serotonin‑reuptake inhibitor, CYP2D6, hyponatremia, serotonin syndrome, dose titration.*