Molindone


Concise Prescribing Info
Indications/Uses
Schizophrenia.
Dosage/Direction for Use
Adult : PO As HCl: Initial: 50-75 mg/day in 3-4 divided doses; may be increased to 100 mg/day after 3 or 4 days. Maintenance: Mild symptoms: 5-15 mg 3-4 times/day; Moderately severe symptoms: 10-25 mg 3-4 times/day; Severe symptoms: Up to 225 mg/day.
Dosage Details
Oral
Schizophrenia
Adult: As hydrochloride: Initially, 50-75 mg daily in 3-4 divided doses; may be increased to 100 mg daily after 3 or 4 days. Maintenance: Mild symptoms: 5-15 mg 3-4 times daily. Moderately severe symptoms: 10-25 mg 3-4 times daily. Severe symptoms: Up to 225 mg daily. A single daily dose is often adequate for maintenance therapy. Patients with resistant mental and emotional disturbances may require wk or mth of treatment.
Elderly: and debilitated: Reduce dose.
Contraindications
Coma, severe CNS depression.
Special Precautions
CNS depression. Parkinson's disease. Patients with haemodynamic instability; bone marrow suppression; predisposition to seizures; subcortical brain damage; severe cardiac, hepatic, renal, respiratory disease. Patients at risk of pneumonia. Breast cancer or other prolactin-dependent tumours. May alter temperature regulation or mask toxicity of other drugs. Patients at risk of orthostatic hypotension. Decreased GI motility, urinary retention, benign prostatic hyperplasia, xerostomia or visual problems. May impair ability to drive or operate machinery. Pregnancy and lactation.
Adverse Reactions
Orthostatic hypotension, tachycardia, arrhythmia; extrapyramidal reactions, mental depression, altered central temperature regulation, sedation, drowsiness, restlessness, anxiety, hyperactivity, euphoria, seizure; pruritus, rash, photosensitivity; menstrual irregularities, oedema of breasts, galactorrhoea, gynaecomastia; constipation, xerostomia, nausea, salivation, wt gain/loss; urinary retention, priapism; leukopenia, leukocytosis; blurred vision, retinal pigmentation; decreased diaphoresis.
Potentially Fatal: Neuroleptic malignant syndrome (NMS).
Overdosage
Symptoms: Deep sleep, extrapyramidal symptoms, cardiac arrhythmias, seizures, hypotension. Management: Symptom-directed and supportive.
Drug Interactions
Increased risk of antipsychotic-related extrapyramidal symptoms with central acetylcholinesterase inhibitors, metoclopramide. Therapeutic response may be inhibited by anticholinergics (e.g. benztropine, trihexyphenidyl, biperiden, TCAs, antihistamines, disopyramide) and anticholinergic crisis may occur. May have additive hypotensive effects with antihypertensive agents, trazodone. May inhibit the effect of bromocriptine on prolactin levels. May cause additive sedation with barbiturates, benzodiazepines, opioid analgesics, ethanol. May produce neurotoxicity with lithium. Serum concentration may be increased with propranolol, sulfadoxine-pyrimethamine.
Potentially Fatal: Amphetamines may increase psychotic symptoms; may reduce efficacy of amphetamines. May inhibit antiparkinsonian effect of levodopa.
Food Interaction
Additive CNS depression may occur with kava kava, gotu kola, valerian, St John's wort.
Action
Description: Molindone is a dihydroindoline antipsychotic with general properties similar to those of chlorpromazine.
Duration: 24-36 hr.
Pharmacokinetics:
Absorption: Readily absorbed after oral doses; peak concentrations of unchanged drug within about 1.5 hr.
Metabolism: Hepatic; rapidly and extensively metabolised.
Excretion: Via urine and faeces (mainly as metabolites and <2-3% as unchanged drug). Elimination half-life: 1.5 hr.
Storage
Store at 25°C (77°F). Protect from light.
MIMS Class
Disclaimer: This information is independently developed by MIMS based on Molindone 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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