Fluphenazine

Tranquilizer, Sedative/Hypnotic · Phenothiazine

Indications

Maintenance treatment of psychotic disorders particularly schizophrenia.

Dosage

INJECTION: Adults: Initially 12.5 mg by deep IM inj into gluteal region to test susceptibility to extra-pyramidal reactions, then adjust dose according to response. Usual dosage range, 12.5 mg to 100 mg every two to five wk. Elderly, initial test dose of 6.25 mg, then same as adults. Children: Not recommended. ORAL: Adults: Psychopsis: 0.5-10 mg daily in divided doses at 6-8 hourly interval; max 40 mg/day. Children: Childhood onset pervasive development disorder: 0.4 mg/kg/day.

Administration

Administered by IM injection. For IM and SC injection, use at least a 21G needle. Stability: Intact vials should be stored at controlled room temperature and protected from freezing and light. Solutions that are darker than light amber, are discoloured in some other way, or contain a precipitate should not be used.

Adverse Effects

Leucopenia, hyperprolactinaemia, acute dystonias and dyskinesias, akathisia, Parkinsonism, drowsiness, insomnia, agitation, tachycardia, arrhythmias, ECG changes, hypotension, anticholinergic effects (e.g. dry month, blurred vision), respiratory depression, nasal stuffiness, rash, photosensitivity, hyperglycaemia, impaired temperature regulation, male sexual dysfunction. Rarely, agranulocytosis, tardive dyskinesia, jaundice, neuroleptic malignant syndrome, pigmentary retinopathy.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Risk cannot be ruled out. Lactation: Caution advised or effect undetermined. Contraindications: Pheochromocytoma, renal or hepatic failure, marked cerebral atherosclerosis, severe cardiac insufficiency, comatose states, severe depression, blood dyscrasias. Precautions: Liver, respiratory or cardiac disease, cardiac arrhythmias, thyrotoxicosis, epilepsy, glaucoma, hypothyroidism, Myasthaenia gravis, prostatic hypertrophy. Parkinson's disease; reduce dose or use anti-Parkinsonian drugs in patients showing extra-pyramidal reactions. Very hot weather. Elderly. Withdraw gradually.

Interactions

Adrenaline, alcohol, barbiturates, CNS depressants, other antipsychotics, anticholinergics, antacids, dopaminergics, lithium, oral hypoglycaemics, antihypertensives, anticonvulsants, drugs that prolong the QT interval (e.g. anti-arrhythmics), sibutramine, metoclopramide.

Advice to Patient

Take as directed by prescriber. Avoid alcohol and caffeine during therapy. Oral solution may be diluted with water, milk, orange juice or grapefruit juice. Do not dilute with beverages containing caffeine, tannin or pectin (e.g. coffee, cola, tea or apple juice). Do not take medication within 2 hours of taking an antacid. Contact prescriber if there is severe dizziness, fast heartbeat, chest pain, palpitations, increased sleepiness, trembling in fingers, change in gait, seizures, anxiety, unusual movements, abnormal thoughts, changes in personality, change in urinary pattern, change in menstrual pattern, change in libido, change in vision, swelling or pain in breasts (male/female), skin rash, skin irritation, yellowing of skin or if there is worsening of condition. Empty bladder before taking medication. Avoid medication contact with skin. Wash immediately with warm, soapy water if…

Pharmacokinetics

Onset: Oral/IM (HCl): <1 hr. IM (other): 24-72 hrs. Duration: Oral/IM (HCl): 6-8 hrs. IM depot: 1-6 wks. Absorption: Oral: Well-absorbed. SC/IM: Slowly absorbed from site of administration. Metabolism: Hepatic. Half-life elimination: Oral: 14-15 hrs. IM: 6-9 days. Time to peak, plasma: Oral: 30 mins. IM (HCl): 1.5-2 hrs. Excretion: Urine. Faeces.

Brands with this active ingredient

Compiled by Healify Pharmacy from published drug references. How we compile it →

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