narebox 4mg tablet - Reboxetine (4mg) medicine

Reboxetine 4mg Tablet: Complete Medicine Guide

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🏭 Zydus Cadila 📦 Varies by brand 💊 Allopathy 📅 Updated: Sep 25, 2026
⚠️ Nephrotoxicity Risk 📋 Prescription Required 💊 Generic Available
Medically Reviewed
11 min read
Evidence: Moderate
Reviewed by
SaathiMed Expert Panel | Sep 25, 2026

When to Call Your Doctor IMMEDIATELY

  • Severe headache with blurred vision or chest pain
  • Palpitations or irregular heartbeat
  • Seizures or loss of consciousness
  • Swelling of face, lips, or throat
  • Difficulty breathing
  • Yellowing of skin or eyes
  • Decreased urine output

If experiencing severe symptoms, call emergency services immediately.

What is narebox 4mg tablet used for?

Reboxetine 4 mg is an antidepressant that works by increasing noradrenaline in the brain. It is used to treat major depressive disorder and is taken twice daily. It requires a prescription and should not be stopped abruptly.

  • Generic Name: Reboxetine (4mg)
  • Manufacturer: Zydus Cadila
  • Form: Allopathy
  • Pregnancy Category: Consult doctor
  • Prescription Required: Yes

🇮🇳 narebox 4mg tablet के बारे में (Hindi Summary)

उपयोग: यह दवा रेबॉक्सेटीन 4 मिलीग्राम टैबलेट के रूप में उपलब्ध है और इसका उपयोग अवसाद (डिप्रेशन) के इलाज के लिए किया जाता है। यह मस्तिष्क में नॉरएड्रेनालाईन नामक रसायन की मात्रा बढ़ाकर मूड को बेहतर बनाने में मदद करती है। यह दवा केवल डॉक्टर के पर्चे पर ही मिलती है और इसे डॉक्टर के बताए अनुसार ही लेना चाहिए।

साइड इफेक्ट्स: इस दवा के सामान्य दुष्प्रभावों में मुँह सूखना, कब्ज, अत्यधिक पसीना, नींद न आना, चक्कर आना और पेशाब करने में कठिनाई शामिल हैं। कुछ मामलों में दिल की धड़कन तेज हो सकती है या रक्तचाप बढ़ सकता है। गंभीर दुष्प्रभाव दुर्लभ हैं, लेकिन यदि आपको सीने में दर्द, सांस लेने में तकलीफ, दौरे या एलर्जी हो तो तुरंत डॉक्टर से संपर्क करें।

सुरक्षा सलाह: इस दवा को डॉक्टर के बताए अनुसार ही लें। इसे अचानक बंद न करें, क्योंकि इससे withdrawal symptoms हो सकते हैं। शराब का सेवन न करें क्योंकि इससे चक्कर और नींद आ सकती है। यदि आप गर्भवती हैं, स्तनपान करा रही हैं, या आपको उच्च रक्तचाप, हृदय रोग, दौरे या जिगर/गुर्दे की समस्या है, तो डॉक्टर को बताएं।

💡 Did You Know? India has the highest number of USFDA-compliant plants outside the USA.

💊 narebox 4mg tablet Uses & Benefits

[{"condition":"Major depressive disorder","description":"This medicine is used to treat symptoms of depression such as persistent sadness, loss of interest, and fatigue.","evidence":"Well-established"},{"condition":"Anxiety disorders","description":"Sometimes prescribed for anxiety symptoms, though not a first-line treatment.","evidence":"Limited"}]

Off-label uses: [{"condition":"Attention deficit hyperactivity disorder (ADHD)","description":"Occasionally used off-label for ADHD symptoms, but evidence is limited.","evidence":"Limited"},{"condition":"Panic disorder","description":"May be used off-label in some cases, but not standard.","evidence":"Limited"}]

Primary treatment for: Major depressive disorder

Also treats: Anxiety disorders, Panic disorder

📋 Drug Information

Generic Name(s)Reboxetine (4mg)
Brand Namenarebox 4mg tablet
ManufacturerZydus Cadila
Packaging / FormVaries by brand (Allopathy)
Therapeutic ClassNEURO CNS
Action ClassSelective norepinephrine reuptake inhibitor (NRI)
Route of AdministrationOral
StorageStore at room temperature (15-30°C) in a dry place, away from direct sunlight and moisture.
Shelf Life24 months from the date of manufacture.
WHO GuidelineNot established from the available information.
ICMR GuidelineNot established from the available information.

👨‍⚕️ Doctor's Practical Tips

Evidence-based practical advice from experienced clinicians

1
Take this medicine at the same time each day to maintain consistent blood levels.
2
Do not stop this medicine abruptly; consult your doctor for a gradual taper.
3
Monitor your blood pressure regularly while on this medicine.
4
Report any new or worsening suicidal thoughts immediately.
5
Avoid alcohol and recreational drugs while taking this medicine.
6
Inform your doctor if you experience sexual dysfunction; dose adjustment may help.

🔍 Is This Medicine Right for Your Symptom?

Educational reference. Always consult a doctor for diagnosis.

✅
Persistent sadness
This medicine is commonly prescribed for depression.
Likely Use
❌
Fever
This medicine is not a fever reducer.
Not Primary

🔬 How This Medicine Works (Pharmacology)

Pharmacokinetics

AbsorptionReboxetine is rapidly absorbed after oral administration. Food does not significantly affect its absorption.
DistributionReboxetine is widely distributed in the body. It is approximately 97% bound to plasma proteins.
Protein BindingApproximately 97%
MetabolismReboxetine is extensively metabolized in the liver, primarily by CYP3A4 enzymes.
Half-LifeThe elimination half-life of reboxetine is approximately 13 hours.
ExcretionReboxetine and its metabolites are primarily excreted in the urine.
BioavailabilityThe absolute bioavailability of reboxetine is approximately 94%.
Onset of ActionThe onset of antidepressant effect may take 2 to 4 weeks.
Peak Plasma TimePeak plasma concentrations are reached about 2 hours after oral administration.
Duration of ActionThe duration of action is not precisely defined, but the half-life suggests effects lasting throughout the day.

How It Works

Reboxetine selectively inhibits the reuptake of noradrenaline at the presynaptic neuron, leading to increased noradrenaline availability in the synaptic cleft. This enhances noradrenergic neurotransmission, which is thought to contribute to its antidepressant effects. It has minimal effect on serotonin reuptake, distinguishing it from selective serotonin reuptake inhibitors.

Mechanism Steps

1
Binding to noradrenaline transporter: Reboxetine binds to the noradrenaline transporter (NET) on presynaptic neurons.
2
Inhibition of reuptake: This binding inhibits the reuptake of noradrenaline back into the presynaptic neuron.
3
Increased noradrenaline in synapse: As a result, noradrenaline accumulates in the synaptic cleft.
4
Enhanced neurotransmission: The increased noradrenaline enhances noradrenergic neurotransmission, which is believed to alleviate depressive symptoms.

💡 How to Take narebox 4mg tablet

Strength: 4 mg immediate-release tablet

1Take this medicine exactly as prescribed by your doctor.
2Swallow the tablet whole with a glass of water.
3You can take it with or without food.
4Take it at the same times each day to maintain consistent levels.
5Do not crush, chew, or break the tablet unless advised by your doctor.

Dosage Information

Adult DosageThe usual adult dose of this medicine is 4 mg taken twice daily (morning and evening). In some cases, the dose may be increased to 10 mg per day after 3-4 weeks based on clinical response and tolerability. Dose must be individualized by a qualified clinician based on indication, age, weight, renal and hepatic function.
Pediatric DosagePediatric dosing is not established from available information. Consult a pediatrician.
Elderly DosageElderly patients may be more sensitive to the effects of this medicine. Start with a lower dose and titrate slowly. Dose must be individualized by a qualified clinician.
Renal ImpairmentUse with caution in patients with renal impairment. Dose adjustment may be necessary. Consult a doctor.
Hepatic ImpairmentUse with caution in patients with hepatic impairment. Dose adjustment may be necessary. Consult a doctor.
Maximum Daily Dose10 mg per day

Dosage Timeline

🌅 Morning ❌ ☀️ Afternoon ❌ 🌆 Evening ❌ 🌙 Night ❌

🍽️ Food Timing Guide

With or without food
Take consistently
Food does not significantly affect absorption.
Grapefruit
Avoid
May increase drug levels.

⏰ What to Do If You Miss a Dose

📌 Less than half the dosing interval has passed
→ Take the missed dose as soon as you remember.
💡 Continue with the regular schedule.
📌 More than half the dosing interval has passed
→ Skip the missed dose.
💡 Do not double dose to catch up.

⚠️ Side Effects of narebox 4mg tablet

✅ Common Side Effects

Dry mouth (Common (5-10%))
Sip water frequently or chew sugar-free gum. Consult doctor if persistent.
Constipation (Common (5-10%))
Increase fiber and fluid intake. Consult doctor if no relief.
Excessive sweating (Common (5-10%))
Stay cool and hydrated. Consult doctor if bothersome.
Insomnia (Common (5-10%))
Take medicine in the morning. Practice good sleep hygiene.
Dizziness (Common (5-10%))
Rise slowly from sitting or lying position. Avoid driving if affected.

🚨 Serious Side Effects

Severe hypertension (Rare (<0.1%))
Seek immediate medical attention if you experience severe headache, blurred vision, or chest pain.
Cardiac arrhythmias (Rare (<0.1%))
Seek immediate medical attention if you notice palpitations, fainting, or shortness of breath.
Seizures (Rare (<0.1%))
Seek immediate medical attention if you experience convulsions or loss of consciousness.
Allergic reactions (Rare (<0.1%))
Seek immediate medical attention if you develop rash, swelling of face/lips/throat, or difficulty breathing.

⚠️ Rare Side Effects

Hyponatremia
Report symptoms like confusion, headache, or weakness to your doctor.
Liver enzyme elevation
Regular liver function tests may be needed. Report jaundice or abdominal pain.

Consult your doctor if you experience any unusual symptoms.

🔬 Drug Interactions

Drug Severity Effect
MAO inhibitors Major
CYP3A4 inhibitors Major
CYP3A4 inducers Moderate
Antihypertensives Moderate
Diuretics Minor

🚨 Major Interactions

  • MAO inhibitors
  • CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin)

⚡ Moderate Interactions

  • CYP3A4 inducers (e.g., rifampicin, carbamazepine)
  • Antihypertensives

🍷 Alcohol Interaction

Avoid alcohol while taking this medicine, as it can increase dizziness, drowsiness, and impair judgment.

🔎 Check Your Other Medicines

Educational tool. Always confirm with your doctor or pharmacist.

🛡️ Safety & Warnings

🚫 Contraindications

["Hypersensitivity to reboxetine or any component of the formulation","Concurrent use with MAO inhibitors","Uncontrolled hypertension","Severe cardiovascular disease","History of seizures","Pregnancy and lactation unless clearly needed"]

⚠️ Warnings & Precautions

["May increase risk of suicidal thoughts in young adults, especially at initiation.","Use with caution in patients with a history of seizures.","May cause orthostatic hypotension; advise patients to rise slowly.","Avoid abrupt discontinuation to prevent withdrawal symptoms.","Use with caution in patients with hepatic or renal impairment.","May impair ability to drive or operate machinery."]

🤱 Lactation Safety

Not established from the available information. Consult a doctor before breastfeeding.

💊 Overdose Management

Overdose may cause severe hypertension, tachycardia, and cardiac arrhythmias. Seek immediate medical attention. Treatment is supportive and symptomatic. There is no specific antidote.

⏰ Missed Dose

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose.

Additional Safety Advice

General Safety

Take this medicine exactly as prescribed by your doctor. Do not exceed the recommended dose. This medicine may cause dizziness or drowsiness; avoid driving or operating heavy machinery until you know how it affects you. Avoid alcohol while taking this medicine, as it can worsen dizziness and drowsiness. Inform your doctor if you have a history of high blood pressure, heart disease, seizures, liver or kidney problems, or if you are pregnant, planning to become pregnant, or breastfeeding. Do not stop this medicine abruptly without consulting your doctor, as withdrawal symptoms may occur. Keep this medicine out of the reach of children. Store it at room temperature, away from moisture and direct sunlight.

👴 Special Considerations for Elderly

💡 For Patients Above 65

Elderly patients may be more sensitive to side effects such as dizziness and low blood pressure. Start with a lower dose and monitor closely.

🤰 Pregnancy Planning (TTC)

If you are planning to become pregnant, consult your doctor. The safety of this medicine during pregnancy is not well established. Your doctor may consider alternative treatments.

🏥 Post-Surgery Considerations

Inform your surgeon and anesthesiologist that you are taking this medicine. It may interact with certain anesthetic agents and affect blood pressure.

🦷 Dental Procedures

Inform your dentist that you are taking this medicine. It may cause dry mouth, which can affect oral health. Maintain good oral hygiene.

💚 Lifestyle Tips for Better Results

🏃
Maintain a regular sleep schedule.
🥗
Engage in regular physical activity as tolerated.
😴
Practice stress-reduction techniques like meditation.
💧
Stay connected with supportive friends and family.
🧘
Avoid alcohol and illicit drugs.

🏋️ Exercise Considerations

This medicine may cause dizziness or fatigue; avoid strenuous exercise until you know how it affects you. Stay hydrated during exercise.

🥗 Diet Recommendations

Eat a balanced diet rich in fruits and vegetables.
Include omega-3 fatty acids.
Limit caffeine and alcohol.
Stay well hydrated.

💼 Impact on Daily Work & Life

This medicine may impair your ability to drive or operate machinery, especially when starting treatment or changing doses. Avoid these activities until you know how it affects you.

🛑 When to Stop This Medicine

Do not stop this medicine without consulting your doctor. If you experience serious side effects or no improvement after several weeks, your doctor may adjust or change the treatment.

📅 Long-Term Use Effects

Long-term use may require regular monitoring of blood pressure, heart rate, and liver function. Some patients may experience persistent sexual dysfunction. Periodic review of the need for continued treatment is advised.

🌿 Non-Medicine Approaches

These can complement medicine but do not replace prescribed treatment.

Cognitive behavioral therapy (CBT)

Can be used alone or in combination with medication for depression.

Evidence: Well-established
Regular exercise

Has been shown to improve mood in mild to moderate depression.

Evidence: Well-established

💉 Vaccination Considerations

💉 If You're Getting Vaccinated

No specific interactions with vaccines are established. Consult your doctor before any vaccination.

📦 Storage Guide

✅ DO

Store at room temperature (15-30°C)

❌ DON'T

Do not refrigerate unless specified

✅ DO

Keep in original container

❌ DON'T

Do not transfer to unmarked containers

✅ DO

Keep away from direct sunlight

❌ DON'T

Do not store in bathroom cabinet

✈️ Traveling with This Medicine

Carry this medicine in its original packaging with a copy of your prescription. Keep it in your carry-on luggage. Store at room temperature, away from direct sunlight. If traveling across time zones, adjust dosing times gradually in consultation with your doctor. Check customs regulations for controlled substances.

💰 Cost Analysis & Savings

👥 Real Patient Stories

Educational, anonymized scenarios. Individual results may vary.

👤 A 35-year-old woman with major depressive disorder
She was started on this medicine 4 mg twice daily. After 3 weeks, she noticed improved mood and energy. She experienced dry mouth initially, which subsided. She was advised not to stop the medicine suddenly.
💡 Lesson: Consistent use and patience are key; side effects often diminish over time.
👤 A 50-year-old man with depression and hypertension
He was prescribed this medicine with caution due to his high blood pressure. His doctor monitored his BP regularly and adjusted his antihypertensive dose. He reported feeling better after 4 weeks.
💡 Lesson: Regular monitoring is essential, especially with pre-existing conditions.

💬 Questions Patients Often Ask

Q: How long does it take to work?

A: It may take 2 to 4 weeks to see full antidepressant effects.

Q: Can I stop this medicine suddenly?

A: No, stopping suddenly can cause withdrawal symptoms. Consult your doctor for a gradual taper.

🤔 Common Patient Concerns

💭 These are the concerns patients most commonly raise

  • Can I take this medicine long-term?
  • Will it affect my blood pressure?
  • Can I drive after taking this medicine?
  • Does it interact with my other medicines?
  • What if I miss a dose?
  • Can I drink alcohol while taking this?

🔄 Substitutes for narebox 4mg tablet

View All

Alternative brands with exact same active ingredient:

Medical Note: Always consult your doctor before switching medications.

🛑 Myths vs. Facts

  • Myth: Reboxetine works immediately.
    Fact: It may take 2 to 4 weeks to see full antidepressant effects.
  • Myth: Reboxetine is addictive.
    Fact: Reboxetine is not considered addictive, but it should not be stopped abruptly without medical advice.

🔄 Alternative Options

Generic Alternatives

  • Reboxetine 4 mg tablet

Brand Alternatives

  • Narebox 4mg Tablet

📊 Comparison with Similar Medicines

[{"medicine":"Reboxetine","class":"Selective noradrenaline reuptake inhibitor","primary_use":"Depression","half_life":"13 hours"},{"medicine":"Fluoxetine","class":"Selective serotonin reuptake inhibitor","primary_use":"Depression","half_life":"4-6 days"}]

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