Jeffrey Panko NP Psychiatry · Patient education
Gepirone
Exxua / Extended-release tablets
A guide for adults taking gepirone.
Follow the directions on your prescription and your provider's recommendations.
Formulations: Exxua is an extended-release tablet taken once daily. Several strengths allow gradual dose adjustments. Kidney function, liver function, age, and interacting medicines can change the appropriate dose.
What it is used for
Gepirone treats major depressive disorder in adults. The goal is improvement in mood, interest, and daily functioning. It is taken regularly, rather than only on difficult days.
How it works
Gepirone activates serotonin 5-HT1A receptors. This affects signaling involved in mood regulation. It is a different type of antidepressant from an SSRI, which blocks serotonin reuptake.
What to expect over time
Sleep, energy, or appetite may change before mood improves. Benefit usually builds over several weeks; some conditions need a longer trial at a useful dose.
Track the symptoms you are treating and how you manage daily activities. Keep follow-up appointments. Schedule an earlier appointment if your mood gets worse.
Taking your medication
- Take once daily with food, at approximately the same time each day.
- Swallow the tablet whole. Do not divide, crush, or chew it.
- Follow the starting schedule; increases are made gradually to assess benefit and tolerability.
- If you miss a dose, take it when you remember unless it is almost time for the next dose. Then skip it. Do not double a dose.
When to get help
Emergency symptoms. Get emergency care for fainting with a fast or irregular heartbeat, a seizure, or a severe allergic reaction. Fever with agitation, diarrhea, and stiff or twitching muscles may be serotonin syndrome.
Prompt medical advice. Contact your provider promptly for persistent palpitations, marked agitation, or unusually high energy with little need for sleep. Report vomiting or diarrhea that could lower electrolytes.
If you feel unsafe or have thoughts of self-harm, call 911 or go to an emergency department.
Possible side effects
- Dizziness or lightheadedness
- Nausea, stomach pain, or indigestion
- Headache
- Trouble sleeping
Keeping track of treatment
Some side effects resolve with time; others may require a change of medication. Discuss persistent or bothersome side effects with your provider.
Antidepressants can increase suicidal thoughts in people under 25. Watch for changes in mood or behavior at any age, especially when starting treatment or changing a dose.
Gepirone can affect the heart’s electrical rhythm. An ECG and blood potassium and magnesium checks are needed before treatment; repeat ECGs are recommended during dose increases and at other times your provider identifies.
If you take too much
For a suspected overdose, call Poison Control at 1-800-222-1222 immediately, even if you feel well. Call 911 for a seizure, collapse, trouble breathing, or inability to wake.
Before you start
Do not use with congenital long-QT syndrome, certain abnormal baseline ECG findings, severe liver impairment, strong CYP3A4 inhibitors, or an MAOI. Tell your provider about fainting, palpitations, heart disease, and prolonged vomiting or diarrhea.
Discuss bipolar disorder, previous mania, kidney disease, and all other medicines.
Discuss pregnancy, pregnancy plans, and breastfeeding with your provider. Treatment decisions should consider both the medication and the condition being treated.
Medicines and interactions
Review all your medications with your provider, including over-the-counter medicines and supplements. Have new medications checked before taking them.
Do not take with an MAOI or within 14 days of stopping one. Wait at least 14 days after stopping gepirone before starting an MAOI. Linezolid and IV methylene blue need specific review.
Some antibiotics, antifungals, antivirals, and seizure medicines substantially change gepirone levels. Medicines that prolong the QT interval add heart-rhythm risk.
Other serotonergic medicines can increase serotonin-syndrome risk. Review grapefruit and alcohol with your provider.
Everyday tips
A regular dose time and refill reminder can help prevent missed doses.
Bring a few specific observations to appointments: sleep, motivation, anxiety, and activities that have become easier or harder.
Your questions answered
Why do I need an ECG if I feel well?
Heart-rhythm changes may develop before symptoms. The ECG helps your provider decide whether treatment and dose increases are appropriate.
What if I feel dizzy after starting?
Stand up slowly and avoid driving while dizzy. Discuss persistent symptoms with your provider. Fainting or an irregular heartbeat needs urgent assessment.
Can I stop when I feel better?
Consult with your provider. Your treatment plan should address how long to continue and how to make any medication change.
Storage and safety
Keep medication in its labeled container, away from excess heat and moisture and out of reach of children and pets. Do not share it. Ask a pharmacy about disposal of unused medication.
Sources
About this information
Educational handout; does not replace your prescription or provider's recommendations.
Educational inclusion does not mean this medication or its indications are treated at this practice. Review the guide for your exact product with your prescriber or pharmacist.