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Ser-Ap-Es

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Overview

What is Ser-Ap-Es?

Ser-Ap-Es is an antihypertensive-diuretic combination, available as tablets for oral administration. Each tablet contains Serpasil (reserpine USP), 0.1 mg; Apresoline (hydralazine hydrochloride USP), 25 mg; and Esidrix (hydrochlorothiazide USP), 15 mg.

      Reserpine is methyl 18β-hydroxy-11,17α-dimethoxy-3β,20α-yohimban-16β-carboxylate 3,4,5-trimethoxybenzoate (ester), and its structural formula is

Reserpine USP, a pure crystalline alkaloid of rauwolfia, is a white or pale buff to slightly yellowish, odorless crystalline powder. It darkens slowly on exposure to light, but more rapidly when in solution. It is insoluble in water, freely soluble in acetic acid and in chloroform, slightly soluble in benzene, and very slightly soluble in alcohol and in ether. Its molecular weight is 608.69.

      Hydralazine hydrochloride is 1-hydrazinophthalazine monohydrochloride, and its structural formula is

Hydralazine hydrochloride USP is a white to off-white, odorless crystalline powder. It is soluble in water, slightly soluble in alcohol, and very slightly soluble in ether. It melts at about 275ºC, with decomposition, and has a molecular weight of 196.64.

      Hydrochlorothiazide is 6-chloro-3,4-dihydro-2-1,2,4-benzothiadiazine-7-sulfonamide 1,1-dioxide, and its structural formula is

Hydrochlorothiazide USP is a white, or practically white, practically odorless crystalline powder. It is slightly soluble in water; freely soluble in sodium hydroxide solution, in -butylamine, and in dimethylformamide; sparingly soluble in methanol; and insoluble in ether, in chloroform, and in dilute mineral acids. Its molecular weight is 297.73.

     . Acacia, FD&C Blue No. 1, FD&C Green No. 3, FD&C Red No. 40, FD&C Yellow No. 6, lactose, polyethylene glycol, starch, stearic acid, and sucrose.



What does Ser-Ap-Es look like?



What are the available doses of Ser-Ap-Es?

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What should I talk to my health care provider before I take Ser-Ap-Es?

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How should I use Ser-Ap-Es?

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What interacts with Ser-Ap-Es?

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What are the warnings of Ser-Ap-Es?

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What are the precautions of Ser-Ap-Es?

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What are the side effects of Ser-Ap-Es?

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What should I look out for while using Ser-Ap-Es?


What might happen if I take too much Ser-Ap-Es?


How should I store and handle Ser-Ap-Es?

Tablets – round, salmon pink, dry-coated (imprinted CIBA 71) 0.1 mg of reserpine, 25 mg of hydralazine hydrochloride, 15 mg of hydrochlorothiazide Bottles of 100.......................................... NDC 0083-0071-30 Bottles of 1000.........................................NDC 0083-0071-40Do not store above 30ºC (86ºF). Dispense in tight, light-resistant container (USP).C97-38 (Rev. 1/98)Novartis Pharmaceuticals CorporationEast Hanover, New Jersey 07936Tablets – round, salmon pink, dry-coated (imprinted CIBA 71) 0.1 mg of reserpine, 25 mg of hydralazine hydrochloride, 15 mg of hydrochlorothiazide Bottles of 100.......................................... NDC 0083-0071-30 Bottles of 1000.........................................NDC 0083-0071-40Do not store above 30ºC (86ºF). Dispense in tight, light-resistant container (USP).C97-38 (Rev. 1/98)Novartis Pharmaceuticals CorporationEast Hanover, New Jersey 07936Tablets – round, salmon pink, dry-coated (imprinted CIBA 71) 0.1 mg of reserpine, 25 mg of hydralazine hydrochloride, 15 mg of hydrochlorothiazide Bottles of 100.......................................... NDC 0083-0071-30 Bottles of 1000.........................................NDC 0083-0071-40Do not store above 30ºC (86ºF). Dispense in tight, light-resistant container (USP).C97-38 (Rev. 1/98)Novartis Pharmaceuticals CorporationEast Hanover, New Jersey 07936Tablets – round, salmon pink, dry-coated (imprinted CIBA 71) 0.1 mg of reserpine, 25 mg of hydralazine hydrochloride, 15 mg of hydrochlorothiazide Bottles of 100.......................................... NDC 0083-0071-30 Bottles of 1000.........................................NDC 0083-0071-40Do not store above 30ºC (86ºF). Dispense in tight, light-resistant container (USP).C97-38 (Rev. 1/98)Novartis Pharmaceuticals CorporationEast Hanover, New Jersey 07936Tablets – round, salmon pink, dry-coated (imprinted CIBA 71) 0.1 mg of reserpine, 25 mg of hydralazine hydrochloride, 15 mg of hydrochlorothiazide Bottles of 100.......................................... NDC 0083-0071-30 Bottles of 1000.........................................NDC 0083-0071-40Do not store above 30ºC (86ºF). Dispense in tight, light-resistant container (USP).C97-38 (Rev. 1/98)Novartis Pharmaceuticals CorporationEast Hanover, New Jersey 07936Tablets – round, salmon pink, dry-coated (imprinted CIBA 71) 0.1 mg of reserpine, 25 mg of hydralazine hydrochloride, 15 mg of hydrochlorothiazide Bottles of 100.......................................... NDC 0083-0071-30 Bottles of 1000.........................................NDC 0083-0071-40Do not store above 30ºC (86ºF). Dispense in tight, light-resistant container (USP).C97-38 (Rev. 1/98)Novartis Pharmaceuticals CorporationEast Hanover, New Jersey 07936Tablets – round, salmon pink, dry-coated (imprinted CIBA 71) 0.1 mg of reserpine, 25 mg of hydralazine hydrochloride, 15 mg of hydrochlorothiazide Bottles of 100.......................................... NDC 0083-0071-30 Bottles of 1000.........................................NDC 0083-0071-40Do not store above 30ºC (86ºF). Dispense in tight, light-resistant container (USP).C97-38 (Rev. 1/98)Novartis Pharmaceuticals CorporationEast Hanover, New Jersey 07936


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Clinical Information

Chemical Structure

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Clinical Pharmacology

Reserpine depletes stores of catecholamines and 5-hydroxytryptamine in many organs, including the brain and adrenal medulla. Most of its pharmacological effects have been attributed to this action. Depletion is slower and less complete in the adrenal medulla than in other tissues.

      The depression of sympathetic nerve function results in a decreased heart rate and a lowering of arterial blood pressure. The sedative and tranquilizing properties of reserpine are thought to be related to depletion of catecholamines and 5-hydroxytryptamine from the brain.

      Reserpine, like other rauwolfia compounds, is characterized by slow onset of action and sustained effects. Both cardiovascular and central nervous system effects may persist for a period of time following withdrawal of the drug.

      Mean maximum plasma levels of 1.54 ng/ml were attained after a median of 3.5 hours in six normal subjects receiving a single oral dose of four 0.25-mg Serpasil tablets.

      Bioavailability was approximately 50% of that of a corresponding intravenous dose. Plasma levels of reserpine after intravenous administration declined with a mean half-life of 33 hours. Reserpine is extensively bound (96%) to plasma proteins. No definitive studies on the human metabolism of reserpine have been made.

Non-Clinical Toxicology
Adverse reactions are usually reversible upon reduction of dosage or discontinuation of Ser-Ap-Es. Whenever adverse reactions are moderate or severe, it may be necessary to discontinue the drug.

The following adverse reactions have been observed, but there has not been enough systematic collection of data to support an estimate of their frequency. Consequently the reactions are categorized by organ system and are listed in decreasing order of severity and not frequency.

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Reference

This information is obtained from the National Institute of Health's Standard Packaging Label drug database.
"https://dailymed.nlm.nih.gov/dailymed/"

While we update our database periodically, we cannot guarantee it is always updated to the latest version.

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Professional

Clonazepam Description Each single-scored tablet, for oral administration, contains 0.5 mg, 1 mg, or 2 mg Clonazepam, USP, a benzodiazepine. Each tablet also contains corn starch, lactose monohydrate, magnesium stearate, microcrystalline cellulose, and povidone. Clonazepam tablets USP 0.5 mg contain Yellow D&C No. 10 Aluminum Lake. Clonazepam tablets USP 1 mg contain Yellow D&C No. 10 Aluminum Lake, as well as FD&C Blue No. 1 Aluminum Lake. Chemically, Clonazepam, USP is 5-(o-chlorophenyl)-1,3-dihydro-7-nitro-2H-1,4-benzodiazepin-2-one. It is a light yellow crystalline powder. It has the following structural formula: C15H10ClN3O3 M.W. 315.72
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Interactions

Interactions

A total of 440 drugs (1549 brand and generic names) are known to interact with Imbruvica (ibrutinib). 228 major drug interactions (854 brand and generic names) 210 moderate drug interactions (691 brand and generic names) 2 minor drug interactions (4 brand and generic names) Show all medications in the database that may interact with Imbruvica (ibrutinib).