Flupentixol


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : PO Psychoses Initial: 3-9 mg twice daily. Max: 18 mg/day. Depression Initial: 1 mg/day, increase to 2 mg/day after 1 wk, then to 3 mg/day. Max: 3 mg/day. IM Psychoses As decanoate: Initial: 20 mg as a test dose. After at least 7 days and depending on response: Subsequent doses of 20-40 mg may be given 2-4 wkly. Usual maintenance: 50 mg 4 wkly to 300 mg 2 wkly, up to 400 mg/wk in severe cases.
Dosage Details
Intramuscular
Psychoses
Adult: As decanoate: Initially, 20 mg (1 ml of a 2% oily solution) is given as test dose. After at least 7 days and depending on the response, subsequent doses of 20-40 mg may be given at intervals of 2-4 wk. Usual maintenance dose: 50 mg every 4 wk to 300 mg every 2 wk. Up to 400 mg wkly may be used in severe or resistant cases.
Elderly: Initial dose: ¼ or ½ of the usual initial dose.

Oral
Depression
Adult: Initially, 1 mg daily increased after 1 wk to 2 mg daily and then to a max of 3 mg daily, last dose should be given not later than 4 p.m. Doses >2 mg should be given in 2 divided doses. Discontinue treatment if there is no improvement within 1 wk of using the max dose.
Elderly: Initially, 0.5 mg daily increased after 1 wk to 1 mg daily with the last dose given not later than 4 p.m. Max: 2 mg daily in 2 divided doses.

Oral
Psychoses
Adult: Initially, 3-9 mg bid, adjusted according to response. Max: 18 mg daily.
Elderly: Initial dose: ¼ or ½ of the usual initial dose.
Administration
May be taken with or without food.
Contraindications
Hypersensitivity. Extremely excitable and overactive patients; mania; porphyria; coma; preexisting CNS depression; bone-marrow supression; phaeochromocytoma. Lactation.
Special Precautions
Patients with convulsive disorders; advanced hepatic, renal, CV or resp disease; tasks requiring mental alertness; elderly (especially with dementia), and debilitated patients; neuroleptics with sedative effect must be withdrawn gradually; history of angle-closure glaucoma; urinary retention; prostatic hyperplasia; breast cancer, prolactin dependent tumours; parkinsonism; myasthenia gravis; pregnancy; Avoid direct sunlight.
Adverse Reactions
Rigidity, tremors, restlessness, tardive dyskinesia, insomnia, dryness of mouth, wt gain, sexual dysfunction, galactorrhoea and menstrual disturbances.
Potentially Fatal: Neuroleptic malignant syndrome (hyperthermia, hypertonicity of skeletal muscles, unconsciousness and autonomic nervous system instability).
Drug Interactions
May potentiate the adverse effects of drugs with antimuscarinic effects e.g. TCAs. Reduced efficacy of levodopa. Increases adverse extrapyramidal symptoms with dopamine antagonists (metoclopramide and prochlorperazine).
Potentially Fatal: Potentiates CNS effects of alcohol, general anaesthetics, hypnotics, anxiolytics and opioids. Blocks antihypertensive effect of guanethidine.
Action
Description: Flupentixol is a thioxanthene antipsychotic that inhibits dopamine-mediated effects by blocking postsynaptic dopamine receptors in the CNS.
Onset: 24-72 hr (IM).
Duration: 2-4 wk (IM).
Pharmacokinetics:
Absorption: Readily absorbed from the GI tract, peak plasma concentrations after 3-8 hr (oral); slowly absorbed from the inj site, peak plasma concentrations after 4-7 days (IM).
Distribution: Crosses the blood-brain barrier and placenta; enters breast milk. >95% bound to plasma proteins.
Metabolism: Extensively hepatic via sulfoxidation, side-chain N-dealkylation and glucuronic acid conjugation.
Excretion: Urine and faeces (as metabolites).
Storage
Store below 25°C.
MIMS Class
Disclaimer: This information is independently developed by MIMS based on Flupentixol from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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