Pipotiazine


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : PO Psychoses 5-20 mg/day. Severe: 30 mg/day. IM  Schizophrenia As pipotiazine palmitate: Initial: 25 mg as test dose, then 25-50 mg after 4-7 days, adjust slowly if needed. Maintenance: 50-100 mg 4 wkly. Max: 200 mg 4 wkly.
Dosage Details
Intramuscular
Schizophrenia
Adult: As pipotiazine palmitate: Initially, 25 mg as test dose followed by 25-50 mg after 4 to 7 days. Adjust in increments of 25-50 mg according to response every 4 wk. Maintenance: 50-100 mg every 4 wk. Max: 200 mg every 4 wk.
Elderly: >50 yr Initially, 5-10 mg.

Oral
Psychoses
Adult: 5-20 mg daily. Severe: 30 mg daily for brief periods.
Renal Impairment
Intramuscular:
Contraindicated.
Hepatic Impairment
Intramuscular: 
Contraindicated
Contraindications
Comatose states, marked cerebral atherosclerosis, phaeochromocytoma, severe cardiac insufficiency. Renal or hepatic impairment.
Special Precautions
Patient w/ or who have history of severe resp disease, epilepsy, alcohol withdrawal symptoms, brain damage, Parkinson’s disease or marked extrapyramidal symptoms w/ previously used neuroleptics, angle-closure glaucoma, hypothyroidism, myasthenia gravis, prostatic hypertrophy, thyrotoxicosis. Elderly. Pregnancy and lactation.
Adverse Reactions
Drowsiness, nasal stuffiness, dry mouth, insomnia, agitation, wt gain, jaundice, hypotension, ECG changes, venous thromboembolism, cardiac arrhythmias, hypokalaemia, pulmonary embolism, mild leukopenia, tardive dyskinesia, akathisia, contact skin sensitisation, photosensitivity, hyperprolactinaemia, ocular change, tremor, rigidity, akinesia, neuroleptic malignant syndrome, glucose intolerance, hyperglycaemia.
Potentially Fatal: Ventricular arrhythmia (torsade de pointes type).
Patient Counseling Information
This drug may cause drowsiness, if affected, do not drive or operate machinery.
MonitoringParameters
Monitor mental status, vital signs, wt, height, BMI, waist circumference, CBC, electrolytes, LFT, glucose level, menstrual cycle, erectile and ejaculatory function, development of galactorrhoea, parkinsonian signs, tardive dyskinesia, ECG and ocular examination.
Overdosage
Symptoms: Drowsiness, loss of consciousness, hypotension, tachycardia, ECG changes, ventricular arrhythmias, hypothermia and severe extrapyramidal dyskinesia. Management: May administer inotropic agent such as dopamine to correct circulatory collapse. Restore normal body temp and correct circulation.
Drug Interactions
Increased risk of arrhythmias when concomitantly used w/ QT prolonging drugs (e.g. antiarrhythmics, antidepressants, other antipsychotics) and drugs causing electrolyte imbalance. Enhanced CNS depressant effect (e.g. resp depression) w/ barbiturates and other sedatives. Increased plasma concentration when used w/ ritonavir. Increased risk of extrapyramidal effects when used w/ tetrabenazine and lithium. Increased neurotoxicity w/ lithium. May increase the hypotensive effect of a α-adrenoceptor blocking agents. Decreased neuroleptic effect when used w/ anticholinergic agents.
Food Interaction
Additive CNS depressant effect w/ alcohol.
Lab Interference
May cause false-positive or negative pregnancy test.
Action
Description: Pipotiazine antagonises postsynaptic mesolimbic dopaminergic receptors in the brain. It depresses the release of hypothalamic and hypophyseal hormones, hence it is less sedating, has less potential to potentiate other CNS depressants and may possess a lower propensity to cause hypotension.
Onset: 2-3 days (IM).
Duration: 3-6 wk.
Pharmacokinetics:
Absorption: Slowly absorbed from the site of inj (IM).
Chemical Structure

Chemical Structure Image
Pipotiazine

Source: National Center for Biotechnology Information. PubChem Database. Pipotiazine, CID=62867, https://pubchem.ncbi.nlm.nih.gov/compound/Pipotiazine (accessed on Jan. 22, 2020)

Storage
Store between 15-30°C.
MIMS Class
ATC Classification
N05AC04 - pipotiazine ; Belongs to the class of phenothiazine antipsychotics with piperidine structure.
References
Anon. Pipotiazine. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 08/07/2016.

Buckingham R (ed). Pipotiazine. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 08/07/2016.

Disclaimer: This information is independently developed by MIMS based on Pipotiazine 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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